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As Passed by the House
136th
General Assembly
Regular
Session
Sub. H. B. No. 253
2025-2026
Representatives John, Young
Cosponsors: Representatives
Schmidt, Somani, Barhorst, Brennan, Brownlee, Hall, D., Lawson-Rowe,
Mathews, T., Newman, Plummer, Ray, Russo, Sigrist, Sims, Tims, White,
A., Williams, Willis, Workman
To
amend sections 2305.234, 2925.01, 2925.23, 2925.55, 2925.56,
3701.048, 3701.74, 3715.872, 3719.121, 3719.13, 3719.81, 4729.01,
4729.51, 4731.22
,
4731.2210
,
4731.25, 4743.09, 4755.48, 4761.01, 4761.03, 4761.032, 4761.06,
4761.061, 4761.07, 4761.09, 4761.13, 4761.14, 4761.17, 4761.30,
4761.99, 4765.51, 4769.01, 5123.47, 5164.95, and 5903.12 and to enact
sections 4761.033, 4761.20, 4761.21, 4761.31, 4761.311, 4761.32,
4761.33, 4761.34, 4761.35, 4761.36, 4761.37, 4761.38, 4761.39,
4761.391, 4761.40, 4761.41, 4761.42, 4761.44, 4761.45, 4761.46, and
4761.49 of the Revised Code
to
license advanced practice respiratory therapists.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section
1.
That
sections 2305.234, 2925.01, 2925.23, 2925.55, 2925.56, 3701.048,
3701.74, 3715.872, 3719.121, 3719.13, 3719.81, 4729.01, 4729.51,
4731.22
,
4731.2210
,
4731.25, 4743.09, 4755.48, 4761.01, 4761.03, 4761.032, 4761.06,
4761.061, 4761.07, 4761.09, 4761.13, 4761.14, 4761.17, 4761.30,
4761.99, 4765.51, 4769.01, 5123.47, 5164.95, and 5903.12 be amended
and sections 4761.033, 4761.20, 4761.21, 4761.31, 4761.311, 4761.32,
4761.33, 4761.34, 4761.35, 4761.36, 4761.37, 4761.38, 4761.39,
4761.391, 4761.40, 4761.41, 4761.42, 4761.44, 4761.45, 4761.46, and
4761.49 of the Revised Code be enacted to read as follows:
Sec.
2305.234.
(A)
As used in this section:
(1)
"Chiropractic claim," "medical claim," and
"optometric claim" have the same meanings as in section
2305.113 of the Revised Code.
(2)
"Dental claim" has the same meaning as in section 2305.113
of the Revised Code, except that it does not include any claim
arising out of a dental operation or any derivative claim for relief
that arises out of a dental operation.
(3)
"Governmental health care program" has the same meaning as
in section 4731.65 of the Revised Code.
(4)
"Health care facility or location" means a hospital,
clinic, ambulatory surgical facility, office of a health care
professional or associated group of health care professionals,
training institution for health care professionals, a free clinic or
other nonprofit shelter or health care facility as those terms are
defined in section 3701.071 of the Revised Code, or any other place
where medical, dental, or other health-related diagnosis, care, or
treatment is provided to a person.
(5)
"Health care professional" means any of the following who
provide medical, dental, or other health-related diagnosis, care, or
treatment:
(a)
Physicians authorized under Chapter 4731. of the Revised Code to
practice medicine and surgery or osteopathic medicine and surgery;
(b)
Advanced practice registered nurses, registered nurses, and licensed
practical nurses licensed under Chapter 4723. of the Revised Code;
(c)
Physician assistants authorized to practice under Chapter 4730. of
the Revised Code;
(d)
Dentists and dental hygienists licensed under Chapter 4715. of the
Revised Code;
(e)
Physical therapists, physical therapist assistants, occupational
therapists, occupational therapy assistants, and athletic trainers
licensed under Chapter 4755. of the Revised Code;
(f)
Chiropractors licensed under Chapter 4734. of the Revised Code;
(g)
Optometrists licensed under Chapter 4725. of the Revised Code;
(h)
Podiatrists authorized under Chapter 4731. of the Revised Code to
practice
podiatry
podiatric
medicine and surgery
;
(i)
Dietitians licensed under Chapter 4759. of the Revised Code;
(j)
Pharmacists licensed under Chapter 4729. of the Revised Code;
(k)
Emergency medical technicians-basic, emergency medical
technicians-intermediate, and emergency medical
technicians-paramedic, certified under Chapter 4765. of the Revised
Code;
(l)
Respiratory care professionals
and
advanced practice respiratory therapists
licensed
under Chapter 4761. of the Revised Code;
(m)
Speech-language pathologists and audiologists licensed under Chapter
4753. of the Revised Code;
(n)
Licensed professional clinical counselors, licensed professional
counselors, independent social workers, social workers, independent
marriage and family therapists, and marriage and family therapists,
licensed under Chapter 4757. of the Revised Code;
(o)
Psychologists licensed under Chapter 4732. of the Revised Code;
(p)
Independent chemical dependency counselors-clinical supervisors,
independent chemical dependency counselors, chemical dependency
counselors III, and chemical dependency counselors II, licensed under
Chapter 4758. of the Revised Code, and chemical dependency counselor
assistants, prevention consultants, prevention specialists,
prevention specialist assistants, and registered applicants,
certified under that chapter;
(q)
Certified mental health assistants licensed under Chapter 4772. of
the Revised Code.
(6)
"Health care worker" means a person other than a health
care professional who provides medical, dental, or other
health-related care or treatment under the direction of a health care
professional with the authority to direct that individual's
activities, including medical technicians, medical assistants, dental
assistants, orderlies, aides, and individuals acting in similar
capacities.
(7)
"Indigent and uninsured person" means a person who meets
both of the following requirements:
(a)
Relative to being indigent, the person's income is not greater than
two hundred per cent of the federal poverty line, as defined by the
United States office of management and budget and revised in
accordance with section 673(2) of the "Omnibus Budget
Reconciliation Act of 1981," 95 Stat. 511, 42 U.S.C. 9902, as
amended
,
except in any case in which division (A)(7)(b)(iii) of this section
includes a person whose income is greater than two hundred per cent
of the federal poverty line
.
(b)
Relative to being uninsured, one of the following applies:
(i)
The person is not a policyholder, certificate holder, insured,
contract holder, subscriber, enrollee, member, beneficiary, or other
covered individual under a health insurance or health care policy,
contract, or plan.
(ii)
The person is a policyholder, certificate holder, insured, contract
holder, subscriber, enrollee, member, beneficiary, or other covered
individual under a health insurance or health care policy, contract,
or plan, but the insurer, policy, contract, or plan denies coverage
or is the subject of insolvency or bankruptcy proceedings in any
jurisdiction.
(iii)
Until
June 30, 2019, the person is eligible for the medicaid program or is
a medicaid recipient.
(iv)
Except as provided in division (A)(7)(b)(iii) of this section, the
The
person
is not eligible for or a recipient, enrollee, or beneficiary of any
governmental health care program.
(8)
"Nonprofit health care referral organization" means an
entity that is not operated for profit and refers patients to, or
arranges for the provision of, health-related diagnosis, care, or
treatment by a health care professional or health care worker.
(9)
"Operation" means any procedure that involves cutting or
otherwise infiltrating human tissue by mechanical means, including
surgery, laser surgery, ionizing radiation, therapeutic ultrasound,
or the removal of intraocular foreign bodies. "Operation"
does not include the administration of medication by injection,
unless the injection is administered in conjunction with a procedure
infiltrating human tissue by mechanical means other than the
administration of medicine by injection. "Operation" does
not include routine dental restorative procedures, the scaling of
teeth, or extractions of teeth that are not impacted.
(10)
"Tort action" means a civil action for damages for injury,
death, or loss to person or property other than a civil action for
damages for a breach of contract or another agreement between persons
or government entities.
(11)
"Volunteer" means an individual who provides any medical,
dental, or other health-care related diagnosis, care, or treatment
without the expectation of receiving and without receipt of any
compensation or other form of remuneration from an indigent and
uninsured person, another person on behalf of an indigent and
uninsured person, any health care facility or location, any nonprofit
health care referral organization, or any other person or government
entity.
(12)
"Community control sanction" has the same meaning as in
section 2929.01 of the Revised Code.
(13)
"Deep sedation" means a drug-induced depression of
consciousness during which a patient cannot be easily aroused but
responds purposefully following repeated or painful stimulation, a
patient's ability to independently maintain ventilatory function may
be impaired, a patient may require assistance in maintaining a patent
airway and spontaneous ventilation may be inadequate, and
cardiovascular function is usually maintained.
(14)
"General anesthesia" means a drug-induced loss of
consciousness during which a patient is not arousable, even by
painful stimulation, the ability to independently maintain
ventilatory function is often impaired, a patient often requires
assistance in maintaining a patent airway, positive pressure
ventilation may be required because of depressed spontaneous
ventilation or drug-induced depression of neuromuscular function, and
cardiovascular function may be impaired.
(B)(1)
Subject to divisions (F) and (G)(3) of this section, a health care
professional who is a volunteer and complies with division (B)(2) of
this section is not liable in damages to any person or government
entity in a tort or other civil action, including an action on a
medical, dental, chiropractic, optometric, or other health-related
claim, for injury, death, or loss to person or property that
allegedly arises from an action or omission of the volunteer in the
provision to an indigent and uninsured person of medical, dental, or
other health-related diagnosis, care, or treatment, including the
provision of samples of medicine and other medical products, unless
the action or omission constitutes willful or wanton misconduct.
(2)
To qualify for the immunity described in division (B)(1) of this
section, a health care professional shall do all of the following
prior to providing diagnosis, care, or treatment:
(a)
Determine, in good faith, that the indigent and uninsured person is
mentally capable of giving informed consent to the provision of the
diagnosis, care, or treatment and is not subject to duress or under
undue influence;
(b)
Inform the person of the provisions of this section, including
notifying the person that, by giving informed consent to the
provision of the diagnosis, care, or treatment, the person cannot
hold the health care professional liable for damages in a tort or
other civil action, including an action on a medical, dental,
chiropractic, optometric, or other health-related claim, unless the
action or omission of the health care professional constitutes
willful or wanton misconduct;
(c)
Obtain the informed consent of the person and a written waiver,
signed by the person or by another individual on behalf of and in the
presence of the person, that states that the person is mentally
competent to give informed consent and, without being subject to
duress or under undue influence, gives informed consent to the
provision of the diagnosis, care, or treatment subject to the
provisions of this section. A written waiver under division (B)(2)(c)
of this section shall state clearly and in conspicuous type that the
person or other individual who signs the waiver is signing it with
full knowledge that, by giving informed consent to the provision of
the diagnosis, care, or treatment, the person cannot bring a tort or
other civil action, including an action on a medical, dental,
chiropractic, optometric, or other health-related claim, against the
health care professional unless the action or omission of the health
care professional constitutes willful or wanton misconduct.
(3)
A physician or podiatrist who is not covered by medical malpractice
insurance, but complies with division (B)(2) of this section, is not
required to comply with division (A) of section 4731.143 of the
Revised Code.
(C)
Subject to divisions (F) and (G)(3) of this section, health care
workers who are volunteers are not liable in damages to any person or
government entity in a tort or other civil action, including an
action upon a medical, dental, chiropractic, optometric, or other
health-related claim, for injury, death, or loss to person or
property that allegedly arises from an action or omission of the
health care worker in the provision to an indigent and uninsured
person of medical, dental, or other health-related diagnosis, care,
or treatment, unless the action or omission constitutes willful or
wanton misconduct.
(D)
Subject to divisions (F) and (G)(3) of this section, a nonprofit
health care referral organization is not liable in damages to any
person or government entity in a tort or other civil action,
including an action on a medical, dental, chiropractic, optometric,
or other health-related claim, for injury, death, or loss to person
or property that allegedly arises from an action or omission of the
nonprofit health care referral organization in referring indigent and
uninsured persons to, or arranging for the provision of, medical,
dental, or other health-related diagnosis, care, or treatment by a
health care professional described in division (B)(1) of this section
or a health care worker described in division (C) of this section,
unless the action or omission constitutes willful or wanton
misconduct.
(E)
Subject to divisions (F) and (G)(3) of this section and to the extent
that the registration requirements of section 3701.071 of the Revised
Code apply, a health care facility or location associated with a
health care professional described in division (B)(1) of this
section, a health care worker described in division (C) of this
section, or a nonprofit health care referral organization described
in division (D) of this section is not liable in damages to any
person or government entity in a tort or other civil action,
including an action on a medical, dental, chiropractic, optometric,
or other health-related claim, for injury, death, or loss to person
or property that allegedly arises from an action or omission of the
health care professional or worker or nonprofit health care referral
organization relative to the medical, dental, or other health-related
diagnosis, care, or treatment provided to an indigent and uninsured
person on behalf of or at the health care facility or location,
unless the action or omission constitutes willful or wanton
misconduct.
(F)(1)
Except as provided in division (F)(2) of this section, the immunities
provided by divisions (B), (C), (D), and (E) of this section are not
available to a health care professional, health care worker,
nonprofit health care referral organization, or health care facility
or location if, at the time of an alleged injury, death, or loss to
person or property, the health care professionals or health care
workers involved are providing one of the following:
(a)
Any medical, dental, or other health-related diagnosis, care, or
treatment pursuant to a community service work order entered by a
court under division (B) of section 2951.02 of the Revised Code or
imposed by a court as a community control sanction;
(b)
Performance of an operation to which any one of the following
applies:
(i)
The operation requires the administration of deep sedation or general
anesthesia.
(ii)
The operation is a procedure that is not typically performed in an
office.
(iii)
The individual involved is a health care professional, and the
operation is beyond the scope of practice or the education, training,
and competence, as applicable, of the health care professional.
(c)
Delivery of a baby or any other purposeful termination of a human
pregnancy.
(2)
Division (F)(1) of this section does not apply when a health care
professional or health care worker provides medical, dental, or other
health-related diagnosis, care, or treatment that is necessary to
preserve the life of a person in a medical emergency.
(G)(1)
This section does not create a new cause of action or substantive
legal right against a health care professional, health care worker,
nonprofit health care referral organization, or health care facility
or location.
(2)
This section does not affect any immunities from civil liability or
defenses established by another section of the Revised Code or
available at common law to which a health care professional, health
care worker, nonprofit health care referral organization, or health
care facility or location may be entitled in connection with the
provision of emergency or other medical, dental, or other
health-related diagnosis, care, or treatment.
(3)
This section does not grant an immunity from tort or other civil
liability to a health care professional, health care worker,
nonprofit health care referral organization, or health care facility
or location for actions that are outside the scope of authority of
health care professionals or health care workers.
In
the case of the diagnosis, care, or treatment of an indigent and
uninsured person who is eligible for the medicaid program or is a
medicaid recipient, this section grants an immunity from tort or
other civil liability only if the person's diagnosis, care, or
treatment is provided in a free clinic, as defined in section
3701.071 of the Revised Code.
(4)
This section does not affect any legal responsibility of a health
care professional, health care worker, or nonprofit health care
referral organization to comply with any applicable law of this state
or rule of an agency of this state.
(5)
This section does not affect any legal responsibility of a health
care facility or location to comply with any applicable law of this
state, rule of an agency of this state, or local code, ordinance, or
regulation that pertains to or regulates building, housing, air
pollution, water pollution, sanitation, health, fire, zoning, or
safety.
Sec.
2925.01.
As
used in this chapter:
(A)
"Administer," "controlled substance," "controlled
substance analog," "dispense," "distribute,"
"hypodermic," "manufacturer," "official
written order," "person," "pharmacist,"
"pharmacy," "sale," "schedule I,"
"schedule II," "schedule III," "schedule
IV," "schedule V," and "wholesaler" have the
same meanings as in section 3719.01 of the Revised Code.
(B)
"Drug of abuse" and "person with a drug dependency"
have the same meanings as in section 3719.011 of the Revised Code.
(C)
"Drug," "dangerous drug," "licensed health
professional authorized to prescribe drugs," and "prescription"
have the same meanings as in section 4729.01 of the Revised Code.
(D)
"Bulk amount" of a controlled substance means any of the
following:
(1)
For any compound, mixture, preparation, or substance included in
schedule I, schedule II, or schedule III, with the exception of any
controlled substance analog, marihuana, cocaine, L.S.D., heroin, any
fentanyl-related compound, and hashish and except as provided in
division (D)(2), (5), or (6) of this section, whichever of the
following is applicable:
(a)
An amount equal to or exceeding ten grams or twenty-five unit doses
of a compound, mixture, preparation, or substance that is or contains
any amount of a schedule I opiate or opium derivative;
(b)
An amount equal to or exceeding ten grams of a compound, mixture,
preparation, or substance that is or contains any amount of raw or
gum opium;
(c)
An amount equal to or exceeding thirty grams or ten unit doses of a
compound, mixture, preparation, or substance that is or contains any
amount of a schedule I hallucinogen other than tetrahydrocannabinol
or lysergic acid amide, or a schedule I stimulant or depressant;
(d)
An amount equal to or exceeding twenty grams or five times the
maximum daily dose in the usual dose range specified in a standard
pharmaceutical reference manual of a compound, mixture, preparation,
or substance that is or contains any amount of a schedule II opiate
or opium derivative;
(e)
An amount equal to or exceeding five grams or ten unit doses of a
compound, mixture, preparation, or substance that is or contains any
amount of phencyclidine;
(f)
An amount equal to or exceeding one hundred twenty grams or thirty
times the maximum daily dose in the usual dose range specified in a
standard pharmaceutical reference manual of a compound, mixture,
preparation, or substance that is or contains any amount of a
schedule II stimulant that is in a final dosage form manufactured by
a person authorized by the "Federal Food, Drug, and Cosmetic
Act," 52 Stat. 1040 (1938), 21 U.S.C.A. 301, as amended, and the
federal drug abuse control laws, as defined in section 3719.01 of the
Revised Code, that is or contains any amount of a schedule II
depressant substance or a schedule II hallucinogenic substance;
(g)
An amount equal to or exceeding three grams of a compound, mixture,
preparation, or substance that is or contains any amount of a
schedule II stimulant, or any of its salts or isomers, that is not in
a final dosage form manufactured by a person authorized by the
Federal Food, Drug, and Cosmetic Act and the federal drug abuse
control laws.
(2)
An amount equal to or exceeding one hundred twenty grams or thirty
times the maximum daily dose in the usual dose range specified in a
standard pharmaceutical reference manual of a compound, mixture,
preparation, or substance that is or contains any amount of a
schedule III or IV substance other than an anabolic steroid or a
schedule III opiate or opium derivative;
(3)
An amount equal to or exceeding twenty grams or five times the
maximum daily dose in the usual dose range specified in a standard
pharmaceutical reference manual of a compound, mixture, preparation,
or substance that is or contains any amount of a schedule III opiate
or opium derivative;
(4)
An amount equal to or exceeding two hundred fifty milliliters or two
hundred fifty grams of a compound, mixture, preparation, or substance
that is or contains any amount of a schedule V substance;
(5)
An amount equal to or exceeding two hundred solid dosage units,
sixteen grams, or sixteen milliliters of a compound, mixture,
preparation, or substance that is or contains any amount of a
schedule III anabolic steroid;
(6)
For any compound, mixture, preparation, or substance that is a
combination of a fentanyl-related compound and any other compound,
mixture, preparation, or substance included in schedule III, schedule
IV, or schedule V, if the defendant is charged with a violation of
section 2925.11 of the Revised Code and the sentencing provisions set
forth in divisions (C)(10)(b) and (C)(11) of that section will not
apply regarding the defendant and the violation, the bulk amount of
the controlled substance for purposes of the violation is the amount
specified in division (D)(1), (2), (3), (4), or (5) of this section
for the other schedule III, IV, or V controlled substance that is
combined with the fentanyl-related compound.
(E)
"Unit dose" means an amount or unit of a compound, mixture,
or preparation containing a controlled substance that is separately
identifiable and in a form that indicates that it is the amount or
unit by which the controlled substance is separately administered to
or taken by an individual.
(F)
"Cultivate" includes planting, watering, fertilizing, or
tilling.
(G)
"Drug abuse offense" means any of the following:
(1)
A violation of division (A) of section 2913.02 that constitutes theft
of drugs, or a violation of section 2925.02, 2925.03, 2925.04,
2925.041, 2925.05, 2925.06, 2925.11, 2925.12, 2925.13, 2925.22,
2925.23, 2925.24, 2925.31, 2925.32, 2925.36, or 2925.37 of the
Revised Code;
(2)
A violation of an existing or former law of this or any other state
or of the United States that is substantially equivalent to any
section listed in division (G)(1) of this section;
(3)
An offense under an existing or former law of this or any other
state, or of the United States, of which planting, cultivating,
harvesting, processing, making, manufacturing, producing, shipping,
transporting, delivering, acquiring, possessing, storing,
distributing, dispensing, selling, inducing another to use,
administering to another, using, or otherwise dealing with a
controlled substance is an element;
(4)
A conspiracy to commit, attempt to commit, or complicity in
committing or attempting to commit any offense under division (G)(1),
(2), or (3) of this section.
(H)
"Felony drug abuse offense" means any drug abuse offense
that would constitute a felony under the laws of this state, any
other state, or the United States.
(I)
"Harmful intoxicant" does not include beer or intoxicating
liquor but means any of the following:
(1)
Any compound, mixture, preparation, or substance the gas, fumes, or
vapor of which when inhaled can induce intoxication, excitement,
giddiness, irrational behavior, depression, stupefaction, paralysis,
unconsciousness, asphyxiation, or other harmful physiological
effects, and includes, but is not limited to, any of the following:
(a)
Any volatile organic solvent, plastic cement, model cement,
fingernail polish remover, lacquer thinner, cleaning fluid, gasoline,
or other preparation containing a volatile organic solvent;
(b)
Any aerosol propellant;
(c)
Any fluorocarbon refrigerant;
(d)
Any anesthetic gas.
(2)
Gamma Butyrolactone;
(3)
1,4 Butanediol.
(J)
"Manufacture" means to plant, cultivate, harvest, process,
make, prepare, or otherwise engage in any part of the production of a
drug, by propagation, extraction, chemical synthesis, or compounding,
or any combination of the same, and includes packaging, repackaging,
labeling, and other activities incident to production.
(K)
"Possess" or "possession" means having control
over a thing or substance, but may not be inferred solely from mere
access to the thing or substance through ownership or occupation of
the premises upon which the thing or substance is found.
(L)
"Sample drug" means a drug or pharmaceutical preparation
that would be hazardous to health or safety if used without the
supervision of a licensed health professional authorized to prescribe
drugs, or a drug of abuse, and that, at one time, had been placed in
a container plainly marked as a sample by a manufacturer.
(M)
"Standard pharmaceutical reference manual" means the
current edition, with cumulative changes if any, of references that
are approved by the state board of pharmacy.
(N)
"Juvenile" means a person under eighteen years of age.
(O)
"Counterfeit controlled substance" means any of the
following:
(1)
Any drug that bears, or whose container or label bears, a trademark,
trade name, or other identifying mark used without authorization of
the owner of rights to that trademark, trade name, or identifying
mark;
(2)
Any unmarked or unlabeled substance that is represented to be a
controlled substance manufactured, processed, packed, or distributed
by a person other than the person that manufactured, processed,
packed, or distributed it;
(3)
Any substance that is represented to be a controlled substance but is
not a controlled substance or is a different controlled substance;
(4)
Any substance other than a controlled substance that a reasonable
person would believe to be a controlled substance because of its
similarity in shape, size, and color, or its markings, labeling,
packaging, distribution, or the price for which it is sold or offered
for sale.
(P)
An offense is "committed in the vicinity of a school" if
the offender commits the offense on school premises, in a school
building, or within one thousand feet of the boundaries of any school
premises, regardless of whether the offender knows the offense is
being committed on school premises, in a school building, or within
one thousand feet of the boundaries of any school premises.
(Q)
"School" means any school operated by a board of education,
any community school established under Chapter 3314. of the Revised
Code, or any nonpublic school for which the director of education and
workforce prescribes minimum standards under section 3301.07 of the
Revised Code, whether or not any instruction, extracurricular
activities, or training provided by the school is being conducted at
the time a criminal offense is committed.
(R)
"School premises" means either of the following:
(1)
The parcel of real property on which any school is situated, whether
or not any instruction, extracurricular activities, or training
provided by the school is being conducted on the premises at the time
a criminal offense is committed;
(2)
Any other parcel of real property that is owned or leased by a board
of education of a school, the governing authority of a community
school established under Chapter 3314. of the Revised Code, or the
governing body of a nonpublic school for which the director of
education and workforce prescribes minimum standards under section
3301.07 of the Revised Code and on which some of the instruction,
extracurricular activities, or training of the school is conducted,
whether or not any instruction, extracurricular activities, or
training provided by the school is being conducted on the parcel of
real property at the time a criminal offense is committed.
(S)
"School building" means any building in which any of the
instruction, extracurricular activities, or training provided by a
school is conducted, whether or not any instruction, extracurricular
activities, or training provided by the school is being conducted in
the school building at the time a criminal offense is committed.
(T)
"Disciplinary counsel" means the disciplinary counsel
appointed by the board of commissioners on grievances and discipline
of the supreme court under the Rules for the Government of the Bar of
Ohio.
(U)
"Certified grievance committee" means a duly constituted
and organized committee of the Ohio state bar association or of one
or more local bar associations of the state of Ohio that complies
with the criteria set forth in Rule V, section 6 of the Rules for the
Government of the Bar of Ohio.
(V)
"Professional license" means any license, permit,
certificate, registration, qualification, admission, temporary
license, temporary permit, temporary certificate, or temporary
registration that is described in divisions (W)(1) to (37) of this
section and that qualifies a person as a professionally licensed
person.
(W)
"Professionally licensed person" means any of the
following:
(1)
A person who has received a certificate or temporary certificate as a
certified public accountant or who has registered as a public
accountant under Chapter 4701. of the Revised Code and who holds an
Ohio permit issued under that chapter;
(2)
A person who holds a certificate of qualification to practice
architecture issued or renewed and registered under Chapter 4703. of
the Revised Code;
(3)
A person who is registered as a landscape architect under Chapter
4703. of the Revised Code or who holds a permit as a landscape
architect issued under that chapter;
(4)
A person licensed under Chapter 4707. of the Revised Code;
(5)
A person who has been issued a barber's license, barber instructor's
license, assistant barber instructor's license, or independent
contractor's license under Chapter 4709. of the Revised Code;
(6)
A person licensed and regulated to engage in the business of a debt
pooling company by a legislative authority, under authority of
Chapter 4710. of the Revised Code;
(7)
A person who has been issued a cosmetologist's license, hair
designer's license, manicurist's license, esthetician's license,
natural hair stylist's license, advanced license to practice
cosmetology, advanced license to practice hair design, advanced
license to practice manicuring, advanced license to practice
esthetics, advanced license to practice natural hair styling,
cosmetology instructor's license, hair design instructor's license,
manicurist instructor's license, esthetics instructor's license,
natural hair style instructor's license, independent contractor's
license, or tanning facility permit under Chapter 4713. of the
Revised Code;
(8)
A person who has been issued a license to practice dentistry, a
general anesthesia permit, a conscious sedation permit, a limited
resident's license, a limited teaching license, a dental hygienist's
license, or a dental hygienist's teacher's certificate under Chapter
4715. of the Revised Code;
(9)
A person who has been issued an embalmer's license, a funeral
director's license, a funeral home license, or a crematory license,
or who has been registered for an embalmer's or funeral director's
apprenticeship under Chapter 4717. of the Revised Code;
(10)
A person who has been licensed as a registered nurse or practical
nurse, or who has been issued a certificate for the practice of
nurse-midwifery under Chapter 4723. of the Revised Code;
(11)
A person who has been licensed to practice optometry or to engage in
optical dispensing under Chapter 4725. of the Revised Code;
(12)
A person licensed to act as a pawnbroker under Chapter 4727. of the
Revised Code;
(13)
A person licensed to act as a precious metals dealer under Chapter
4728. of the Revised Code;
(14)
A person licensed under Chapter 4729. of the Revised Code as a
pharmacist or pharmacy intern or registered under that chapter as a
registered pharmacy technician, certified pharmacy technician, or
pharmacy technician trainee;
(15)
A person licensed under Chapter 4729. of the Revised Code as a
manufacturer of dangerous drugs, outsourcing facility, third-party
logistics provider, repackager of dangerous drugs, wholesale
distributor of dangerous drugs, or terminal distributor of dangerous
drugs;
(16)
A person who is authorized to practice as a physician assistant under
Chapter 4730. of the Revised Code;
(17)
A person who has been issued a license to practice medicine and
surgery, osteopathic medicine and surgery, or podiatric medicine and
surgery under Chapter 4731. of the Revised Code or has been issued a
certificate to practice a limited branch of medicine under that
chapter;
(18)
A person licensed as a psychologist, independent school psychologist,
or school psychologist under Chapter 4732. of the Revised Code;
(19)
A person registered to practice the profession of engineering or
surveying under Chapter 4733. of the Revised Code;
(20)
A person who has been issued a license to practice chiropractic under
Chapter 4734. of the Revised Code;
(21)
A person licensed to act as a real estate broker or real estate
salesperson under Chapter 4735. of the Revised Code;
(22)
A person registered as a registered environmental health specialist
under Chapter 3776. of the Revised Code;
(23)
A person licensed to operate or maintain a junkyard under Chapter
4737. of the Revised Code;
(24)
A person who has been issued a motor vehicle salvage dealer's license
under Chapter 4738. of the Revised Code;
(25)
A person who has been licensed to act as a steam engineer under
Chapter 4739. of the Revised Code;
(26)
A person who has been issued a license or temporary permit to
practice veterinary medicine or any of its branches, or who is
registered as a graduate animal technician under Chapter 4741. of the
Revised Code;
(27)
A person who has been issued a hearing aid dealer's or fitter's
license or trainee permit under Chapter 4747. of the Revised Code;
(28)
A person who has been issued a class A, class B, or class C license
or who has been registered as an investigator or security guard
employee under Chapter 4749. of the Revised Code;
(29)
A person licensed to practice as a nursing home administrator under
Chapter 4751. of the Revised Code;
(30)
A person licensed to practice as a speech-language pathologist or
audiologist under Chapter 4753. of the Revised Code;
(31)
A person issued a license as an occupational therapist or physical
therapist under Chapter 4755. of the Revised Code;
(32)
A person who is licensed as a licensed professional clinical
counselor, licensed professional counselor, social worker,
independent social worker, independent marriage and family therapist,
or marriage and family therapist, or registered as a social work
assistant under Chapter 4757. of the Revised Code;
(33)
A person issued a license to practice dietetics under Chapter 4759.
of the Revised Code;
(34)
A person who has been issued a license or limited permit to practice
respiratory therapy
or
a license to practice as an advanced practice respiratory therapist
under
Chapter 4761. of the Revised Code;
(35)
A person who has been issued a real estate appraiser certificate
under Chapter 4763. of the Revised Code;
(36)
A person who has been issued a home inspector license under Chapter
4764. of the Revised Code;
(37)
A person who has been admitted to the bar by order of the supreme
court in compliance with its prescribed and published rules;
(38)
A person who has been issued a license to practice as a certified
mental health assistant under Chapter 4772. of the Revised Code.
(X)
"Cocaine" means any of the following:
(1)
A cocaine salt, isomer, or derivative, a salt of a cocaine isomer or
derivative, or the base form of cocaine;
(2)
Coca leaves or a salt, compound, derivative, or preparation of coca
leaves, including ecgonine, a salt, isomer, or derivative of
ecgonine, or a salt of an isomer or derivative of ecgonine;
(3)
A salt, compound, derivative, or preparation of a substance
identified in division (X)(1) or (2) of this section that is
chemically equivalent to or identical with any of those substances,
except that the substances shall not include decocainized coca leaves
or extraction of coca leaves if the extractions do not contain
cocaine or ecgonine.
(Y)
"L.S.D." means lysergic acid diethylamide.
(Z)
"Hashish" means a resin or a preparation of a resin to
which both of the following apply:
(1)
It is contained in or derived from any part of the plant of the genus
cannabis, whether in solid form or in a liquid concentrate, liquid
extract, or liquid distillate form.
(2)
It has a delta-9 tetrahydrocannabinol concentration of more than
three-tenths per cent.
"Hashish"
does not include a hemp byproduct in the possession of a licensed
hemp processor under Chapter 928. of the Revised Code, provided that
the hemp byproduct is being produced, stored, and disposed of in
accordance with rules adopted under section 928.03 of the Revised
Code.
(AA)
"Marihuana" has the same meaning as in section 3719.01 of
the Revised Code, except that it does not include hashish.
(BB)
An offense is "committed in the vicinity of a juvenile" if
the offender commits the offense within one hundred feet of a
juvenile or within the view of a juvenile, regardless of whether the
offender knows the age of the juvenile, whether the offender knows
the offense is being committed within one hundred feet of or within
view of the juvenile, or whether the juvenile actually views the
commission of the offense.
(CC)
"Presumption for a prison term" or "presumption that a
prison term shall be imposed" means a presumption, as described
in division (D) of section 2929.13 of the Revised Code, that a prison
term is a necessary sanction for a felony in order to comply with the
purposes and principles of sentencing under section 2929.11 of the
Revised Code.
(DD)
"Major drug offender" has the same meaning as in section
2929.01 of the Revised Code.
(EE)
"Minor drug possession offense" means either of the
following:
(1)
A violation of section 2925.11 of the Revised Code as it existed
prior to July 1, 1996;
(2)
A violation of section 2925.11 of the Revised Code as it exists on
and after July 1, 1996, that is a misdemeanor or a felony of the
fifth degree.
(FF)
"Mandatory prison term" has the same meaning as in section
2929.01 of the Revised Code.
(GG)
"Adulterate" means to cause a drug to be adulterated as
described in section 3715.63 of the Revised Code.
(HH)
"Public premises" means any hotel, restaurant, tavern,
store, arena, hall, or other place of public accommodation, business,
amusement, or resort.
(II)
"Methamphetamine" means methamphetamine, any salt, isomer,
or salt of an isomer of methamphetamine, or any compound, mixture,
preparation, or substance containing methamphetamine or any salt,
isomer, or salt of an isomer of methamphetamine.
(JJ)
"Deception" has the same meaning as in section 2913.01 of
the Revised Code.
(KK)
"Fentanyl-related compound" means any of the following:
(1)
Fentanyl;
(2)
Alpha-methylfentanyl (N-[1-(alpha-methyl-beta-phenyl)ethyl-4-
piperidyl]propionanilide;
1-(1-methyl-2-phenylethyl)-4-(N-propanilido) piperidine);
(3)
Alpha-methylthiofentanyl (N-[1-methyl-2-(2-thienyl)ethyl-4-
piperidinyl]-N-phenylpropanamide);
(4)
Beta-hydroxyfentanyl (N-[1-(2-hydroxy-2-phenethyl-4-piperidinyl]
-N-phenylpropanamide);
(5)
Beta-hydroxy-3-methylfentanyl (other name: N-[1-(2-hydroxy-2-
phenethyl)-3-methyl-4-piperidinyl]-N- phenylpropanamide);
(6)
3-methylfentanyl (N-[3-methyl-1-(2-phenylethyl)-4-piperidyl]-N-
phenylpropanamide);
(7)
3-methylthiofentanyl (N-[3-methyl-1-[2-(thienyl)ethyl]-4-
piperidinyl]-N-phenylpropanamide);
(8)
Para-fluorofentanyl (N-(4-fluorophenyl)-N-[1-(2-phenethyl)-4-
piperidinyl]propanamide;
(9)
Thiofentanyl (N-phenyl-N-[1-(2-thienyl)ethyl-4-piperidinyl]-
propanamide;
(10)
Alfentanil;
(11)
Carfentanil;
(12)
Remifentanil;
(13)
Sufentanil;
(14)
Acetyl-alpha-methylfentanyl (N-[1-(1-methyl-2-phenethyl)-4-
piperidinyl]-N-phenylacetamide); and
(15)
Any compound that meets all of the following fentanyl pharmacophore
requirements to bind at the mu receptor, as identified by a report
from an established forensic laboratory, including acetylfentanyl,
furanylfentanyl, valerylfentanyl, butyrylfentanyl,
isobutyrylfentanyl, 4-methoxybutyrylfentanyl,
para-fluorobutyrylfentanyl, acrylfentanyl, and ortho-fluorofentanyl:
(a)
A chemical scaffold consisting of both of the following:
(i)
A five, six, or seven member ring structure containing a nitrogen,
whether or not further substituted;
(ii)
An attached nitrogen to the ring, whether or not that nitrogen is
enclosed in a ring structure, including an attached aromatic ring or
other lipophilic group to that nitrogen.
(b)
A polar functional group attached to the chemical scaffold, including
but not limited to a hydroxyl, ketone, amide, or ester;
(c)
An alkyl or aryl substitution off the ring nitrogen of the chemical
scaffold; and
(d)
The compound has not been approved for medical use by the United
States food and drug administration.
(LL)
"First degree felony mandatory prison term" means one of
the definite prison terms prescribed in division (A)(1)(b) of section
2929.14 of the Revised Code for a felony of the first degree, except
that if the violation for which sentence is being imposed is
committed on or after March 22, 2019, it means one of the minimum
prison terms prescribed in division (A)(1)(a) of that section for a
felony of the first degree.
(MM)
"Second degree felony mandatory prison term" means one of
the definite prison terms prescribed in division (A)(2)(b) of section
2929.14 of the Revised Code for a felony of the second degree, except
that if the violation for which sentence is being imposed is
committed on or after March 22, 2019, it means one of the minimum
prison terms prescribed in division (A)(2)(a) of that section for a
felony of the second degree.
(NN)
"Maximum first degree felony mandatory prison term" means
the maximum definite prison term prescribed in division (A)(1)(b) of
section 2929.14 of the Revised Code for a felony of the first degree,
except that if the violation for which sentence is being imposed is
committed on or after March 22, 2019, it means the longest minimum
prison term prescribed in division (A)(1)(a) of that section for a
felony of the first degree.
(OO)
"Maximum second degree felony mandatory prison term" means
the maximum definite prison term prescribed in division (A)(2)(b) of
section 2929.14 of the Revised Code for a felony of the second
degree, except that if the violation for which sentence is being
imposed is committed on or after March 22, 2019, it means the longest
minimum prison term prescribed in division (A)(2)(a) of that section
for a felony of the second degree.
(PP)
"Delta-9 tetrahydrocannabinol" has the same meaning as in
section 928.01 of the Revised Code.
(QQ)
An offense is "committed in the vicinity of a substance
addiction services provider or a recovering addict" if either of
the following apply:
(1)
The offender commits the offense on the premises of a substance
addiction services provider's facility, including a facility licensed
prior to June 29, 2019, under section 5119.391 of the Revised Code to
provide methadone treatment or an opioid treatment program licensed
on or after that date under section 5119.37 of the Revised Code, or
within five hundred feet of the premises of a substance addiction
services provider's facility and the offender knows or should know
that the offense is being committed within the vicinity of the
substance addiction services provider's facility.
(2)
The offender sells, offers to sell, delivers, or distributes the
controlled substance or controlled substance analog to a person who
is receiving treatment at the time of the commission of the offense,
or received treatment within thirty days prior to the commission of
the offense, from a substance addiction services provider and the
offender knows that the person is receiving or received that
treatment.
(RR)
"Substance addiction services provider" means an agency,
association, corporation or other legal entity, individual, or
program that provides one or more of the following at a facility:
(1)
Either alcohol addiction services, or drug addiction services, or
both such services that are certified by the director of mental
health and addiction services under section 5119.36 of the Revised
Code;
(2)
Recovery supports that are related to either alcohol addiction
services, or drug addiction services, or both such services and paid
for with federal, state, or local funds administered by the
department of
mental
health and addiction services
behavioral
health
or
a board of alcohol, drug addiction, and mental health services.
(SS)
"Premises of a substance addiction services provider's facility"
means the parcel of real property on which any substance addiction
service provider's facility is situated.
(TT)
"Alcohol and drug addiction services" has the same meaning
as in section 5119.01 of the Revised Code.
Sec.
2925.23.
(A)
No person shall knowingly make a false statement in any prescription,
order, report, or record required by Chapter 3719. or 4729. of the
Revised Code.
(B)
No person shall intentionally make, utter, or sell, or knowingly
possess any of the following that is a false or forged:
(1)
Prescription;
(2)
Uncompleted preprinted prescription blank used for writing a
prescription;
(3)
Official written order;
(4)
License for a terminal distributor of dangerous drugs, as defined in
section 4729.01 of the Revised Code;
(5)
License for a manufacturer of dangerous drugs, outsourcing facility,
third-party logistics provider, repackager of dangerous drugs, or
wholesale distributor of dangerous drugs, as defined in section
4729.01 of the Revised Code.
(C)
No person, by theft as defined in section 2913.02 of the Revised
Code, shall acquire any of the following:
(1)
A prescription;
(2)
An uncompleted preprinted prescription blank used for writing a
prescription;
(3)
An official written order;
(4)
A blank official written order;
(5)
A license or blank license for a terminal distributor of dangerous
drugs, as defined in section 4729.01 of the Revised Code;
(6)
A license or blank license for a manufacturer of dangerous drugs,
outsourcing facility, third-party logistics provider, repackager of
dangerous drugs, or wholesale distributor of dangerous drugs, as
defined in section 4729.01 of the Revised Code.
(D)
No person shall knowingly make or affix any false or forged label to
a package or receptacle containing any dangerous drugs.
(E)
Divisions (A) and (D) of this section do not apply to licensed health
professionals authorized to prescribe drugs, pharmacists, owners of
pharmacies, and other persons whose conduct is in accordance with
Chapters 3719., 4715., 4723., 4725., 4729., 4730., 4731., 4741.,
4761., and
4772. of the Revised Code.
(F)
Whoever violates this section is guilty of illegal processing of drug
documents. If the offender violates division (B)(2), (4), or (5) or
division (C)(2), (4), (5), or (6) of this section, illegal processing
of drug documents is a felony of the fifth degree. If the offender
violates division (A), division (B)(1) or (3), division (C)(1) or
(3), or division (D) of this section, the penalty for illegal
processing of drug documents shall be determined as follows:
(1)
If the drug involved is a compound, mixture, preparation, or
substance included in schedule I or II, with the exception of
marihuana, illegal processing of drug documents is a felony of the
fourth degree, and division (C) of section 2929.13 of the Revised
Code applies in determining whether to impose a prison term on the
offender.
(2)
If the drug involved is a dangerous drug or a compound, mixture,
preparation, or substance included in schedule III, IV, or V or is
marihuana, illegal processing of drug documents is a felony of the
fifth degree, and division (C) of section 2929.13 of the Revised Code
applies in determining whether to impose a prison term on the
offender.
(G)(1)
If the offender is a professionally licensed person, in addition to
any other sanction imposed for a violation of this section, the court
immediately shall comply with section 2925.38 of the Revised Code.
If
the offender has a driver's or commercial driver's license or permit,
section 2929.33 of the Revised Code applies.
(2)
Any offender who received a mandatory suspension of the offender's
driver's or commercial driver's license or permit under this section
prior to September 13, 2016, may file a motion with the sentencing
court requesting the termination of the suspension. However, an
offender who pleaded guilty to or was convicted of a violation of
section 4511.19 of the Revised Code or a substantially similar
municipal ordinance or law of another state or the United States that
arose out of the same set of circumstances as the violation for which
the offender's license or permit was suspended under this section
shall not file such a motion.
Upon
the filing of a motion under division (G)(2) of this section, the
sentencing court, in its discretion, may terminate the suspension.
(H)
Notwithstanding any contrary provision of section 3719.21 of the
Revised Code, the clerk of court shall pay a fine imposed for a
violation of this section pursuant to division (A) of section 2929.18
of the Revised Code in accordance with and subject to the
requirements of division (F) of section 2925.03 of the Revised Code.
The agency that receives the fine shall use the fine as specified in
division (F) of section 2925.03 of the Revised Code.
Sec.
2925.55.
(A)
As used in sections 2925.55 to 2925.58 of the Revised Code:
(1)
"Consumer product" means any food or drink that is consumed
or used by humans and any drug, including a drug that may be provided
legally only pursuant to a prescription, that is intended to be
consumed or used by humans.
(2)
"Terminal distributor of dangerous drugs" has the same
meaning as in section 4729.01 of the Revised Code.
(3)
"Pseudoephedrine" means any material, compound, mixture, or
preparation that contains any quantity of pseudoephedrine, any of its
salts, optical isomers, or salts of optical isomers.
(4)
"Pseudoephedrine product" means a consumer product that
contains pseudoephedrine.
(5)
"Retailer" means a place of business that offers consumer
products for sale to the general public.
(6)
"Single-ingredient preparation" means a compound, mixture,
preparation, or substance that contains a single active ingredient.
(7)
"Ephedrine" means any material, compound, mixture, or
preparation that contains any quantity of ephedrine, any of its
salts, optical isomers, or salts of optical isomers.
(8)
"Ephedrine product" means a consumer product that contains
ephedrine.
(B)(1)
No individual shall knowingly purchase, receive, or otherwise acquire
an amount of pseudoephedrine product or ephedrine product that is
greater than either of the following unless the pseudoephedrine
product or ephedrine product is dispensed by a pharmacist pursuant to
a valid prescription issued by a licensed health professional
authorized to prescribe drugs and the conduct of the pharmacist and
the licensed health professional authorized to prescribe drugs is in
accordance with Chapter 3719., 4715., 4723., 4729., 4730., 4731.,
4741.,
4761.,
or
4772. of the Revised Code:
(a)
Three and six tenths grams within a period of a single day;
(b)
Nine grams within a period of thirty consecutive days.
The
limits specified in divisions (B)(1)(a) and (b) of this section apply
to the total amount of base pseudoephedrine or base ephedrine in the
pseudoephedrine product or ephedrine product, respectively. The
limits do not apply to the product's overall weight.
(2)
It is not a violation of division (B)(1) of this section for an
individual to receive or accept more than an amount of
pseudoephedrine product or ephedrine product specified in division
(B)(1)(a) or (b) of this section if the individual is an employee of
a retailer or terminal distributor of dangerous drugs, and the
employee receives or accepts from the retailer or terminal
distributor of dangerous drugs the pseudoephedrine product or
ephedrine product in a sealed container in connection with
manufacturing, warehousing, placement, stocking, bagging, loading, or
unloading of the product.
(C)(1)
No individual under eighteen years of age shall knowingly purchase,
receive, or otherwise acquire a pseudoephedrine product or ephedrine
product unless the pseudoephedrine product or ephedrine product is
dispensed by a pharmacist pursuant to a valid prescription issued by
a licensed health professional authorized to prescribe drugs and the
conduct of the pharmacist and the licensed health professional
authorized to prescribe drugs is in accordance with Chapter 3719.,
4715., 4723., 4729., 4730., 4731., 4741.,
4761.,
or
4772. of the Revised Code.
(2)
Division (C)(1) of this section does not apply to an individual under
eighteen years of age who purchases, receives, or otherwise acquires
a pseudoephedrine product or ephedrine product from any of the
following:
(a)
A licensed health professional authorized to prescribe drugs or
pharmacist who dispenses, sells, or otherwise provides the
pseudoephedrine product or ephedrine product to that individual and
whose conduct is in accordance with Chapter 3719., 4715., 4723.,
4729., 4730., 4731., 4741.,
4761.,
or
4772. of the Revised Code;
(b)
A parent or guardian of that individual who provides the
pseudoephedrine product or ephedrine product to the individual;
(c)
A person, as authorized by that individual's parent or guardian, who
dispenses, sells, or otherwise provides the pseudoephedrine product
or ephedrine product to the individual;
(d)
A retailer or terminal distributor of dangerous drugs who provides
the pseudoephedrine product or ephedrine product to that individual
if the individual is an employee of the retailer or terminal
distributor of dangerous drugs and the individual receives or accepts
from the retailer or terminal distributor of dangerous drugs the
pseudoephedrine product or ephedrine product in a sealed container in
connection with manufacturing, warehousing, placement, stocking,
bagging, loading, or unloading of the product.
(D)
No individual under eighteen years of age shall knowingly show or
give false information concerning the individual's name, age, or
other identification for the purpose of purchasing, receiving, or
otherwise acquiring a pseudoephedrine product or ephedrine product.
(E)
No individual shall knowingly fail to comply with the requirements of
division (B) of section 3715.051 of the Revised Code.
(F)
Whoever violates division (B)(1) of this section is guilty of
unlawful purchase of a pseudoephedrine product or ephedrine product,
a misdemeanor of the first degree.
(G)
Whoever violates division (C)(1) of this section is guilty of
underage purchase of a pseudoephedrine product or ephedrine product,
a delinquent act that would be a misdemeanor of the fourth degree if
it could be committed by an adult.
(H)
Whoever violates division (D) of this section is guilty of using
false information to purchase a pseudoephedrine product or ephedrine
product, a delinquent act that would be a misdemeanor of the first
degree if it could be committed by an adult.
(I)
Whoever violates division (E) of this section is guilty of improper
purchase of a pseudoephedrine product or ephedrine product, a
misdemeanor of the fourth degree.
Sec.
2925.56.
(A)(1)
Except as provided in division (A)(2) of this section, no retailer or
terminal distributor of dangerous drugs or an employee of a retailer
or terminal distributor of dangerous drugs shall knowingly sell,
offer to sell, hold for sale, deliver, or otherwise provide to any
individual an amount of pseudoephedrine product or ephedrine product
that is greater than either of the following:
(a)
Three and six-tenths grams within a period of a single day;
(b)
Nine grams within a period of thirty consecutive days.
The
maximum amounts specified in divisions (A)(1)(a) and (b) of this
section apply to the total amount of base pseudoephedrine or base
ephedrine in the pseudoephedrine product or ephedrine product,
respectively. The maximum amounts do not apply to the product's
overall weight.
(2)(a)
Division (A)(1) of this section does not apply to any quantity of
pseudoephedrine product or ephedrine product dispensed by a
pharmacist pursuant to a valid prescription issued by a licensed
health professional authorized to prescribe drugs if the conduct of
the pharmacist and the licensed health professional authorized to
prescribe drugs is in accordance with Chapter 3719., 4715., 4723.,
4729., 4730., 4731., 4741.,
4761.,
or
4772. of the Revised Code.
(b)
It is not a violation of division (A)(1) of this section for a
retailer, terminal distributor of dangerous drugs, or employee of
either to provide to an individual more than an amount of
pseudoephedrine product or ephedrine product specified in division
(A)(1)(a) or (b) of this section under either of the following
circumstances:
(i)
The individual is an employee of the retailer or terminal distributor
of dangerous drugs, and the employee receives or accepts from the
retailer, terminal distributor of dangerous drugs, or employee the
pseudoephedrine product or ephedrine product in a sealed container in
connection with manufacturing, warehousing, placement, stocking,
bagging, loading, or unloading of the product;
(ii)
A stop-sale alert is generated after the submission of information to
the national precursor log exchange under the conditions described in
division (A)(2) of section 3715.052 of the Revised Code.
(B)(1)
Except as provided in division (B)(2) of this section, no retailer or
terminal distributor of dangerous drugs or an employee of a retailer
or terminal distributor of dangerous drugs shall sell, offer to sell,
hold for sale, deliver, or otherwise provide a pseudoephedrine
product or ephedrine product to an individual who is under eighteen
years of age.
(2)
Division (B)(1) of this section does not apply to any of the
following:
(a)
A licensed health professional authorized to prescribe drugs or
pharmacist who dispenses, sells, or otherwise provides a
pseudoephedrine product or ephedrine product to an individual under
eighteen years of age and whose conduct is in accordance with Chapter
3719., 4715., 4723., 4729., 4730., 4731., 4741.,
4761.,
or
4772. of the Revised Code;
(b)
A parent or guardian of an individual under eighteen years of age who
provides a pseudoephedrine product or ephedrine product to the
individual;
(c)
A person who, as authorized by the individual's parent or guardian,
dispenses, sells, or otherwise provides a pseudoephedrine product or
ephedrine product to an individual under eighteen years of age;
(d)
The provision by a retailer, terminal distributor of dangerous drugs,
or employee of either of a pseudoephedrine product or ephedrine
product in a sealed container to an employee of the retailer or
terminal distributor of dangerous drugs who is under eighteen years
of age in connection with manufacturing, warehousing, placement,
stocking, bagging, loading, or unloading of the product.
(C)
No retailer or terminal distributor of dangerous drugs shall fail to
comply with the requirements of division (A) of section 3715.051 or
division (A)(2) of section 3715.052 of the Revised Code.
(D)
No retailer or terminal distributor of dangerous drugs shall fail to
comply with the requirements of division (A)(1) of section 3715.052
of the Revised Code.
(E)
Whoever violates division (A)(1) of this section is guilty of
unlawfully selling a pseudoephedrine product or ephedrine product, a
misdemeanor of the first degree.
(F)
Whoever violates division (B)(1) of this section is guilty of
unlawfully selling a pseudoephedrine product or ephedrine product to
a minor, a misdemeanor of the fourth degree.
(G)
Whoever violates division (C) of this section is guilty of improper
sale of a pseudoephedrine product or ephedrine product, a misdemeanor
of the second degree.
(H)
Whoever violates division (D) of this section is guilty of failing to
submit information to the national precursor log exchange, a
misdemeanor for which the offender shall be fined not more than one
thousand dollars per violation.
Sec.
3701.048.
(A)
As used in this section:
(1)
"Board of health" means the board of health of a city or
general health district or the authority having the duties of a board
of health under section 3709.05 of the Revised Code.
(2)
"Controlled substance" has the same meaning as in section
3719.01 of the Revised Code.
(3)
"Drug," "dangerous drug," and "licensed
health professional authorized to prescribe drugs" have the same
meanings as in section 4729.01 of the Revised Code.
(4)
"Registered volunteer" has the same meaning as in section
5502.281 of the Revised Code.
(B)
In consultation with the appropriate professional regulatory boards
of this state, the director of health shall develop one or more
protocols that authorize the following individuals to administer,
deliver, or distribute drugs, other than schedule II and III
controlled substances, during a period of time described in division
(E) of this section, notwithstanding any statute or rule that
otherwise prohibits or restricts the administration, delivery, or
distribution of drugs by those individuals:
(1)
A physician authorized under Chapter 4731. of the Revised Code to
practice medicine and surgery, osteopathic medicine and surgery, or
podiatric medicine and surgery;
(2)
A physician assistant licensed under Chapter 4730. of the Revised
Code;
(3)
A dentist or dental hygienist licensed under Chapter 4715. of the
Revised Code;
(4)
A registered nurse licensed under Chapter 4723. of the Revised Code,
including an advanced practice registered nurse, as defined in
section 4723.01 of the Revised Code;
(5)
A licensed practical nurse licensed under Chapter 4723. of the
Revised Code;
(6)
An optometrist licensed under Chapter 4725. of the Revised Code;
(7)
A pharmacist or pharmacy intern licensed under Chapter 4729. of the
Revised Code;
(8)
A respiratory care professional
or
advanced practice respiratory therapist
licensed
under Chapter 4761. of the Revised Code;
(9)
An emergency medical technician-basic, emergency medical
technician-intermediate, or emergency medical technician-paramedic
who holds a certificate to practice issued under Chapter 4765. of the
Revised Code;
(10)
A veterinarian licensed under Chapter 4741. of the Revised Code;
(11)
A certified mental health assistant licensed under Chapter 4772. of
the Revised Code.
(C)
In consultation with the executive director of the emergency
management agency, the director of health shall develop one or more
protocols that authorize employees of boards of health and registered
volunteers to deliver or distribute drugs, other than schedule II and
III controlled substances, during a period of time described in
division (E) of this section, notwithstanding any statute or rule
that otherwise prohibits or restricts the delivery or distribution of
drugs by those individuals.
(D)
In consultation with the state board of pharmacy, the director of
health shall develop one or more protocols that authorize pharmacists
and pharmacy interns to dispense, during a period of time described
in division (E) of this section, limited quantities of dangerous
drugs, other than schedule II and III controlled substances, without
a written, oral, or electronic prescription from a licensed health
professional authorized to prescribe drugs or without a record of a
prescription, notwithstanding any statute or rule that otherwise
prohibits or restricts the dispensing of drugs without a prescription
or record of a prescription.
(E)
On the governor's declaration of an emergency that affects the public
health, the director of health may issue an order to implement one or
more of the protocols developed pursuant to division (B), (C), or (D)
of this section. At a minimum, the director's order shall identify
the one or more protocols to be implemented and the period of time
during which the one or more protocols are to be effective.
(F)(1)
An individual who administers, delivers, distributes, or dispenses a
drug or dangerous drug in accordance with one or more of the
protocols implemented under division (E) of this section is not
liable for damages in any civil action unless the individual's acts
or omissions in performing those activities constitute willful or
wanton misconduct.
(2)
An individual who administers, delivers, distributes, or dispenses a
drug or dangerous drug in accordance with one or more of the
protocols implemented under division (E) of this section is not
subject to criminal prosecution or professional disciplinary action
under any chapter in Title XLVII of the Revised Code.
Sec.
3701.74.
(A)
As used in this section and section 3701.741 of the Revised Code:
(1)
"Ambulatory care facility" means a facility that provides
medical, diagnostic, or surgical treatment to patients who do not
require hospitalization, including a dialysis center, ambulatory
surgical facility, cardiac catheterization facility, diagnostic
imaging center, extracorporeal shock wave lithotripsy center, home
health agency, inpatient hospice, birthing center, radiation therapy
center, emergency facility, and an urgent care center. "Ambulatory
care facility" does not include the private office of a
physician, advanced practice registered nurse, or dentist, whether
the office is for an individual or group practice.
(2)
"Chiropractor" means an individual licensed under Chapter
4734. of the Revised Code to practice chiropractic.
(3)
"Emergency facility" means a hospital emergency department
or any other facility that provides emergency medical services.
(4)
"Health care practitioner" means all of the following:
(a)
A dentist or dental hygienist licensed under Chapter 4715. of the
Revised Code;
(b)
A registered nurse licensed under Chapter 4723. of the Revised Code,
including an advanced practice registered nurse, or a licensed
practical nurse licensed under that chapter;
(c)
An optometrist licensed under Chapter 4725. of the Revised Code;
(d)
A dispensing optician,
whether
a
spectacle
dispensing optician
,
or spectacle-contact lens dispensing optician
,
licensed under Chapter 4725. of the Revised Code;
(e)
A pharmacist licensed under Chapter 4729. of the Revised Code;
(f)
A physician;
(g)
A physician assistant authorized under Chapter 4730. of the Revised
Code to practice as a physician assistant;
(h)
A practitioner of a limited branch of medicine issued a license or
certificate under Chapter 4731. of the Revised Code;
(i)
A psychologist licensed under Chapter 4732. of the Revised Code;
(j)
A chiropractor;
(k)
A hearing aid dealer or fitter licensed under Chapter 4747. of the
Revised Code;
(l)
A speech-language pathologist or audiologist licensed under Chapter
4753. of the Revised Code;
(m)
An occupational therapist or occupational therapy assistant licensed
under Chapter 4755. of the Revised Code;
(n)
A physical therapist or physical therapy assistant licensed under
Chapter 4755. of the Revised Code;
(o)
A licensed professional clinical counselor, licensed professional
counselor, social worker, independent social worker, independent
marriage and family therapist, or marriage and family therapist
licensed, or a social work assistant registered, under Chapter 4757.
of the Revised Code;
(p)
A dietitian licensed under Chapter 4759. of the Revised Code;
(q)
A respiratory care professional
or
advanced practice respiratory therapist
licensed
under Chapter 4761. of the Revised Code;
(r)
An emergency medical technician-basic, emergency medical
technician-intermediate, or emergency medical technician-paramedic
certified under Chapter 4765. of the Revised Code;
(s)
A certified mental health assistant licensed under Chapter 4772. of
the Revised Code.
(5)
"Health care provider" means a hospital, ambulatory care
facility, long-term care facility, pharmacy, emergency facility, or
health care practitioner.
(6)
"Hospital" has the same meaning as in section 3727.01 of
the Revised Code.
(7)
"Long-term care facility" means a nursing home, residential
care facility, or home for the aging, as those terms are defined in
section 3721.01 of the Revised Code; a residential facility licensed
under section 5119.34 of the Revised Code that provides
accommodations, supervision, and personal care services for three to
sixteen unrelated adults; a nursing facility, as defined in section
5165.01 of the Revised Code; a skilled nursing facility, as defined
in section 5165.01 of the Revised Code; and an intermediate care
facility for individuals with intellectual disabilities, as defined
in section 5124.01 of the Revised Code.
(8)
"Medical record" means data in any form that pertains to a
patient's medical history, diagnosis, prognosis, or medical condition
and that is generated and maintained by a health care provider in the
process of the patient's health care treatment.
(9)
"Medical records company" means a person who stores,
locates, or copies medical records for a health care provider, or is
compensated for doing so by a health care provider, and charges a fee
for providing medical records to a patient or patient's
representative.
(10)
"Patient" means either of the following:
(a)
An individual who received health care treatment from a health care
provider;
(b)
A guardian, as defined in section 1337.11 of the Revised Code, of an
individual described in division (A)(10)(a) of this section.
(11)
"Patient's personal representative" means a minor patient's
parent or other person acting in loco parentis, a court-appointed
guardian, or a person with durable power of attorney for health care
for a patient, the executor or administrator of the patient's estate,
or the person responsible for the patient's estate if it is not to be
probated. "Patient's personal representative" does not
include an insurer authorized under Title XXXIX of the Revised Code
to do the business of sickness and accident insurance in this state,
a health insuring corporation holding a certificate of authority
under Chapter 1751. of the Revised Code, or any other person not
named in this division.
(12)
"Pharmacy" has the same meaning as in section 4729.01 of
the Revised Code.
(13)
"Physician" means a person authorized under Chapter 4731.
of the Revised Code to practice medicine and surgery, osteopathic
medicine and surgery, or podiatric medicine and surgery.
(14)
"Authorized person" means a person to whom a patient has
given written authorization to act on the patient's behalf regarding
the patient's medical record.
(15)
"Advanced practice registered nurse" has the same meaning
as in section 4723.01 of the Revised Code.
(B)
A patient, a patient's personal representative, or an authorized
person who wishes to examine or obtain a copy of part or all of a
medical record shall submit to the health care provider a written
request signed by the patient, personal representative, or authorized
person dated not more than one year before the date on which it is
submitted. The request shall indicate whether the copy is to be sent
to the requestor, sent to a physician, advanced practice registered
nurse, or chiropractor, or held for the requestor at the office of
the health care provider. Within a reasonable time after receiving a
request that meets the requirements of this division and includes
sufficient information to identify the record requested, a health
care provider that has the patient's medical records shall permit the
patient to examine the record during regular business hours without
charge or, on request, shall provide a copy of the record in
accordance with section 3701.741 of the Revised Code, except that if
a physician, advanced practice registered nurse, psychologist,
licensed professional clinical counselor, licensed professional
counselor, independent social worker, social worker, independent
marriage and family therapist, marriage and family therapist, or
chiropractor who has treated the patient determines for clearly
stated treatment reasons that disclosure of the requested record is
likely to have an adverse effect on the patient, the health care
provider shall provide the record to a physician, advanced practice
registered nurse, psychologist, licensed professional clinical
counselor, licensed professional counselor, independent social
worker, social worker, independent marriage and family therapist,
marriage and family therapist, or chiropractor designated by the
patient. The health care provider shall take reasonable steps to
establish the identity of the person making the request to examine or
obtain a copy of the patient's record.
(C)
If a health care provider fails to furnish a medical record as
required by division (B) of this section, the patient, personal
representative, or authorized person who requested the record may
bring a civil action to enforce the patient's right of access to the
record.
(D)(1)
This section does not apply to medical records whose release is
covered by section 173.20 or 3721.13 of the Revised Code, by Chapter
1347., 5119., or 5122. of the Revised Code, by 42 C.F.R. part 2,
"Confidentiality of Alcohol and Drug Abuse Patient Records,"
or by 42 C.F.R. 483.10.
(2)
Nothing in this section is intended to supersede the confidentiality
provisions of sections 2305.24, 2305.25, 2305.251, and 2305.252 of
the Revised Code.
Sec.
3715.872.
(A)
As used in this section, "health care professional" means
any of the following who provide medical, dental, or other
health-related diagnosis, care, or treatment:
(1)
Individuals authorized under Chapter 4731. of the Revised Code to
practice medicine and surgery, osteopathic medicine and surgery, or
podiatric medicine and surgery;
(2)
Registered nurses licensed under Chapter 4723. of the Revised Code,
including advanced practice registered nurses, and licensed practical
nurses licensed under that chapter;
(3)
Physician assistants licensed under Chapter 4730. of the Revised
Code;
(4)
Dentists and dental hygienists licensed under Chapter 4715. of the
Revised Code;
(5)
Optometrists licensed under Chapter 4725. of the Revised Code;
(6)
Pharmacists licensed under Chapter 4729. of the Revised Code;
(7)
Certified mental health assistants licensed under Chapter 4772. of
the Revised Code
;
(8)
Advanced practice respiratory therapists licensed under Chapter 4761.
of the Revised Code
.
(B)
For matters related to activities conducted under the drug repository
program, all of the following apply:
(1)
A pharmacy, drug manufacturer, health care facility, or other person
or government entity that donates or gives drugs to the program, and
any person or government entity that facilitates the donation or
gift, shall not be subject to liability in tort or other civil action
for injury, death, or loss to person or property.
(2)
A pharmacy, hospital, or nonprofit clinic that accepts or distributes
drugs under the program shall not be subject to liability in tort or
other civil action for injury, death, or loss to person or property,
unless an action or omission of the pharmacy, hospital, or nonprofit
clinic constitutes willful and wanton misconduct.
(3)
A health care professional who accepts, dispenses, or personally
furnishes drugs under the program on behalf of a pharmacy, hospital,
or nonprofit clinic participating in the program, and the pharmacy,
hospital, or nonprofit clinic that employs or otherwise uses the
services of the health care professional, shall not be subject to
liability in tort or other civil action for injury, death, or loss to
person or property, unless an action or omission of the health care
professional, pharmacy, hospital, or nonprofit clinic constitutes
willful and wanton misconduct.
(4)
The state board of pharmacy shall not be subject to liability in tort
or other civil action for injury, death, or loss to person or
property, unless an action or omission of the board constitutes
willful and wanton misconduct.
(5)
In addition to the civil immunity granted under division (B)(1) of
this section, a pharmacy, drug manufacturer, health care facility, or
other person or government entity that donates or gives drugs to the
program, and any person or government entity that facilitates the
donation or gift, shall not be subject to criminal prosecution for
matters related to activities that it conducts or another party
conducts under the program, unless an action or omission of the party
that donates, gives, or facilitates the donation or gift of the drugs
does not comply with the provisions of this chapter or the rules
adopted under it.
(6)
In the case of a drug manufacturer, the immunities from civil
liability and criminal prosecution granted to another party under
divisions (B)(1) and (5) of this section extend to the manufacturer
when any drug it manufactures is the subject of an activity conducted
under the program. This extension of immunities includes, but is not
limited to, immunity from liability or prosecution for failure to
transfer or communicate product or consumer information or the
expiration date of a drug that is donated or given.
Sec.
3719.121.
(A)
Except as otherwise provided in section 4723.28, 4723.35, 4730.25,
4731.22, 4734.39, 4734.41,
4761.09,
or
4772.20 of the Revised Code, the license, certificate, or
registration of any dentist, chiropractor, physician, podiatrist,
registered nurse, advanced practice registered nurse, licensed
practical nurse, physician assistant,
advanced
practice respiratory therapist,
pharmacist,
pharmacy intern, pharmacy technician trainee, registered pharmacy
technician, certified pharmacy technician, optometrist, veterinarian,
or certified mental health assistant who is or becomes addicted to
the use of controlled substances shall be suspended by the board that
authorized the person's license, certificate, or registration until
the person offers satisfactory proof to the board that the person no
longer is addicted to the use of controlled substances.
(B)
If the board under which a person has been issued a license,
certificate, or evidence of registration determines that there is
clear and convincing evidence that continuation of the person's
professional practice or method of administering, prescribing,
preparing, distributing, dispensing, or personally furnishing
controlled substances or other dangerous drugs presents a danger of
immediate and serious harm to others, the board may suspend the
person's license, certificate, or registration without a hearing.
Except as otherwise provided in sections 4715.30, 4723.281, 4729.16,
4730.25, 4731.22, 4734.36,
4761.09,
and
4772.20 of the Revised Code, the board shall follow the procedure for
suspension without a prior hearing in section 119.07 of the Revised
Code. The suspension shall remain in effect, unless removed by the
board, until the board's final adjudication order becomes effective,
except that if the board does not issue its final adjudication order
within ninety days after the hearing, the suspension shall be void on
the ninety-first day after the hearing.
(C)
On receiving notification pursuant to section 2929.42 or 3719.12 of
the Revised Code, the board under which a person has been issued a
license, certificate, or evidence of registration immediately shall
suspend the license, certificate, or registration of that person on a
plea of guilty to, a finding by a jury or court of the person's guilt
of, or conviction of a felony drug abuse offense; a finding by a
court of the person's eligibility for intervention in lieu of
conviction; a plea of guilty to, or a finding by a jury or court of
the person's guilt of, or the person's conviction of an offense in
another jurisdiction that is essentially the same as a felony drug
abuse offense; or a finding by a court of the person's eligibility
for treatment or intervention in lieu of conviction in another
jurisdiction. The board shall notify the holder of the license,
certificate, or registration of the suspension, which shall remain in
effect until the board holds an adjudicatory hearing under Chapter
119. of the Revised Code.
Sec.
3719.13.
Prescriptions,
orders, and records, required by Chapter 3719. of the Revised Code,
and stocks of dangerous drugs and controlled substances, shall be
open for inspection only to federal, state, county, and municipal
officers, and employees of the state board of pharmacy whose duty it
is to enforce the laws of this state or of the United States relating
to controlled substances. Such prescriptions, orders, records, and
stocks shall be open for inspection by employees of the state medical
board for purposes of enforcing Chapters 4730., 4731.,
4761.,
and
4772. of the Revised Code, employees of the board of nursing for
purposes of enforcing Chapter 4723. of the Revised Code, and
employees of the department of
mental
health and addiction services
behavioral
health
for
purposes of section 5119.37 of the Revised Code. No person having
knowledge of any such prescription, order, or record shall divulge
such knowledge, except in connection with a prosecution or proceeding
in court or before a licensing or registration board or officer, to
which prosecution or proceeding the person to whom such
prescriptions, orders, or records relate is a party.
Sec.
3719.81.
(A)
As used in this section, "sample drug" has the same meaning
as in section 2925.01 of the Revised Code.
(B)
A person may furnish another a sample drug, if all of the following
apply:
(1)
The sample drug is furnished free of charge by a manufacturer,
manufacturer's representative, or wholesale dealer in pharmaceuticals
to a licensed health professional authorized to prescribe drugs,
other
than an advanced practice respiratory therapist,
or
is furnished free of charge by
such
a professional
the
prescriber who received the sample drug
to
a patient for use as medication;
(2)
The sample drug is in the original container in which it was placed
by the manufacturer, and the container is plainly marked as a sample;
(3)
Prior to its being furnished, the sample drug has been stored under
the proper conditions to prevent its deterioration or contamination;
(4)
If the sample drug is of a type which deteriorates with time, the
sample container is plainly marked with the date beyond which the
sample drug is unsafe to use, and the date has not expired on the
sample furnished. Compliance with the labeling requirements of the
"Federal Food, Drug, and Cosmetic Act," 52 Stat. 1040
(1938), 21 U.S.C.A. 301, as amended, shall be deemed compliance with
this section.
(5)
The sample drug is distributed, stored, or discarded in such a way
that the sample drug may not be acquired or used by any unauthorized
person, or by any person, including a child, for whom it may present
a health or safety hazard.
(C)
Division (B) of this section does not do any of the following:
(1)
Apply to or restrict the furnishing of any sample of a nonnarcotic
substance if the substance may, under the "Federal Food, Drug,
and Cosmetic Act" and under the laws of this state, otherwise be
lawfully sold over the counter without a prescription;
(2)
Authorize a
licensed
health professional authorized to prescribe drugs
prescriber
who
is a clinical nurse specialist, certified nurse-midwife, certified
nurse practitioner, optometrist, physician assistant, or certified
mental health assistant to furnish a sample drug that is not a drug
the
professional
prescriber
is
authorized to prescribe.
(3)
Prohibit a
licensed
health professional authorized to prescribe drugs
prescriber
,
manufacturer of dangerous drugs, wholesale distributor of dangerous
drugs, or representative of a manufacturer of dangerous drugs from
furnishing a sample drug to a charitable pharmacy in accordance with
section 3719.811 of the Revised Code.
(4)
Prohibit a pharmacist working, whether or not for compensation, in a
charitable pharmacy from dispensing a sample drug to a person in
accordance with section 3719.811 of the Revised Code.
(D)
The state board of pharmacy shall, in accordance with Chapter 119. of
the Revised Code, adopt rules as necessary to give effect to this
section.
Sec.
4729.01.
As
used in this chapter:
(A)
"Pharmacy," except when used in a context that refers to
the practice of pharmacy, means any area, room, rooms, place of
business, department, or portion of any of the foregoing where the
practice of pharmacy is conducted.
(B)
"Practice of pharmacy" means providing pharmacist care
requiring specialized knowledge, judgment, and skill derived from the
principles of biological, chemical, behavioral, social,
pharmaceutical, and clinical sciences. As used in this division,
"pharmacist care" includes the following:
(1)
Interpreting prescriptions;
(2)
Dispensing drugs and drug therapy related devices;
(3)
Compounding drugs;
(4)
Counseling individuals with regard to their drug therapy,
recommending drug therapy related devices, and assisting in the
selection of drugs and appliances for treatment of common diseases
and injuries and providing instruction in the proper use of the drugs
and appliances;
(5)
Performing drug regimen reviews with individuals by discussing all of
the drugs that the individual is taking and explaining the
interactions of the drugs;
(6)
Performing drug utilization reviews with licensed health
professionals authorized to prescribe drugs when the pharmacist
determines that an individual with a prescription has a drug regimen
that warrants additional discussion with the prescriber;
(7)
Advising an individual and the health care professionals treating an
individual with regard to the individual's drug therapy;
(8)
Acting pursuant to a consult agreement, if an agreement has been
established;
(9)
Engaging in the administration of immunizations to the extent
authorized by section 4729.41 of the Revised Code;
(10)
Engaging in the administration of drugs to the extent authorized by
section 4729.45 of the Revised Code.
(C)
"Compounding" means the preparation, mixing, assembling,
packaging, and labeling of one or more drugs in any of the following
circumstances:
(1)
Pursuant to a prescription issued by a licensed health professional
authorized to prescribe drugs;
(2)
Pursuant to the modification of a prescription made in accordance
with a consult agreement;
(3)
As an incident to research, teaching activities, or chemical
analysis;
(4)
In anticipation of orders for drugs pursuant to prescriptions, based
on routine, regularly observed dispensing patterns;
(5)
Pursuant to a request made by a licensed health professional
authorized to prescribe drugs for a drug that is to be used by the
professional for the purpose of direct administration to patients in
the course of the professional's practice, if all of the following
apply:
(a)
At the time the request is made, the drug is not commercially
available regardless of the reason that the drug is not available,
including the absence of a manufacturer for the drug or the lack of a
readily available supply of the drug from a manufacturer.
(b)
A limited quantity of the drug is compounded and provided to the
professional.
(c)
The drug is compounded and provided to the professional as an
occasional exception to the normal practice of dispensing drugs
pursuant to patient-specific prescriptions.
(D)
"Consult agreement" means an agreement that has been
entered into under section 4729.39 of the Revised Code.
(E)
"Drug" means:
(1)
Any article recognized in the United States pharmacopoeia and
national formulary, or any supplement to them, intended for use in
the diagnosis, cure, mitigation, treatment, or prevention of disease
in humans or animals;
(2)
Any other article intended for use in the diagnosis, cure,
mitigation, treatment, or prevention of disease in humans or animals;
(3)
Any article, other than food, intended to affect the structure or any
function of the body of humans or animals;
(4)
Any article intended for use as a component of any article specified
in division (E)(1), (2), or (3) of this section; but does not include
devices or their components, parts, or accessories.
"Drug"
does not include "hemp" or a "hemp product" as
those terms are defined in section 928.01 of the Revised Code.
(F)
"Dangerous drug" means any of the following:
(1)
Any drug to which either of the following applies:
(a)
Under the "Federal Food, Drug, and Cosmetic Act," 52 Stat.
1040 (1938), 21 U.S.C.A. 301, as amended, the drug is required to
bear a label containing the legend "Caution: Federal law
prohibits dispensing without prescription" or "Caution:
Federal law restricts this drug to use by or on the order of a
licensed veterinarian" or any similar restrictive statement, or
the drug may be dispensed only upon a prescription;
(b)
Under Chapter 3715. or 3719. of the Revised Code, the drug may be
dispensed only upon a prescription.
(2)
Any drug that contains a schedule V controlled substance and that is
exempt from Chapter 3719. of the Revised Code or to which that
chapter does not apply;
(3)
Any drug intended for administration by injection into the human body
other than through a natural orifice of the human body;
(4)
Any drug that is a biological product, as defined in section 3715.01
of the Revised Code.
(G)
"Federal drug abuse control laws" has the same meaning as
in section 3719.01 of the Revised Code.
(H)
"Prescription" means all of the following:
(1)
A written, electronic, or oral order for drugs or combinations or
mixtures of drugs to be used by a particular individual or for
treating a particular animal, issued by a licensed health
professional authorized to prescribe drugs;
(2)
For purposes of sections 4723.4810, 4729.282, 4730.432, and 4731.93
of the Revised Code, a written, electronic, or oral order for a drug
to treat chlamydia, gonorrhea, or trichomoniasis issued to and in the
name of a patient who is not the intended user of the drug but is the
sexual partner of the intended user;
(3)
For purposes of sections 3313.7110, 3313.7111, 3314.143, 3326.28,
3328.29, 4723.483, 4729.88, 4730.433, 4731.96, and 5180.26 of the
Revised Code, a written, electronic, or oral order for an epinephrine
autoinjector issued to and in the name of a school, school district,
or camp;
(4)
For purposes of Chapter 3728. and sections 4723.483, 4729.88,
4730.433, and 4731.96 of the Revised Code, a written, electronic, or
oral order for an epinephrine autoinjector issued to and in the name
of a qualified entity, as defined in section 3728.01 of the Revised
Code;
(5)
For purposes of sections 3313.7115, 3313.7116, 3314.147, 3326.60,
3328.38, 4723.4811, 4730.437, 4731.92, and 5180.262 of the Revised
Code, a written, electronic, or oral order for injectable or nasally
administered glucagon in the name of a school, school district, or
camp.
(I)
"Licensed health professional authorized to prescribe drugs"
or "prescriber" means an individual who is authorized by
law to prescribe drugs or dangerous drugs or drug therapy related
devices in the course of the individual's professional practice,
including only the following:
(1)
A dentist licensed under Chapter 4715. of the Revised Code;
(2)
A clinical nurse specialist, certified nurse-midwife, or certified
nurse practitioner who holds a current, valid license issued under
Chapter 4723. of the Revised Code to practice nursing as an advanced
practice registered nurse;
(3)
A certified registered nurse anesthetist who holds a current, valid
license issued under Chapter 4723. of the Revised Code to practice
nursing as an advanced practice registered nurse, but only to the
extent of the nurse's authority under sections 4723.43 and 4723.434
of the Revised Code;
(4)
An optometrist licensed under Chapter 4725. of the Revised Code to
practice optometry;
(5)
A physician authorized under Chapter 4731. of the Revised Code to
practice medicine and surgery, osteopathic medicine and surgery, or
podiatric medicine and surgery;
(6)
A physician assistant who holds a license to practice as a physician
assistant issued under Chapter 4730. of the Revised Code, holds a
valid prescriber number issued by the state medical board, and has
been granted physician-delegated prescriptive authority;
(7)
A veterinarian licensed under Chapter 4741. of the Revised Code;
(8)
An
advanced practice respiratory therapist who holds a license to
practice as an advanced practice registered nurse issued under
Chapter 4761. of the Revised Code and has been granted
physician-delegated prescriptive authority;
(9)
A
certified mental health assistant licensed under Chapter 4772. of the
Revised Code who has been granted physician-delegated prescriptive
authority by the physician supervising the certified mental health
assistant.
(J)
"Sale" or "sell" includes any transaction made by
any person, whether as principal proprietor, agent, or employee, to
do or offer to do any of the following: deliver, distribute, broker,
exchange, gift or otherwise give away, or transfer, whether the
transfer is by passage of title, physical movement, or both.
(K)
"Wholesale sale" and "sale at wholesale" mean any
sale in which the purpose of the purchaser is to resell the article
purchased or received by the purchaser.
(L)
"Retail sale" and "sale at retail" mean any sale
other than a wholesale sale or sale at wholesale.
(M)
"Retail seller" means any person that sells any dangerous
drug to consumers without assuming control over and responsibility
for its administration. Mere advice or instructions regarding
administration do not constitute control or establish responsibility.
(N)
"Price information" means the price charged for a
prescription for a particular drug product and, in an easily
understandable manner, all of the following:
(1)
The proprietary name of the drug product;
(2)
The established (generic) name of the drug product;
(3)
The strength of the drug product if the product contains a single
active ingredient or if the drug product contains more than one
active ingredient and a relevant strength can be associated with the
product without indicating each active ingredient. The established
name and quantity of each active ingredient are required if such a
relevant strength cannot be so associated with a drug product
containing more than one ingredient.
(4)
The dosage form;
(5)
The price charged for a specific quantity of the drug product. The
stated price shall include all charges to the consumer, including,
but not limited to, the cost of the drug product, professional fees,
handling fees, if any, and a statement identifying professional
services routinely furnished by the pharmacy. Any mailing fees and
delivery fees may be stated separately without repetition. The
information shall not be false or misleading.
(O)
"Wholesale distributor of dangerous drugs" or "wholesale
distributor" means a person engaged in the sale of dangerous
drugs at wholesale and includes any agent or employee of such a
person authorized by the person to engage in the sale of dangerous
drugs at wholesale.
(P)
"Manufacturer of dangerous drugs" or "manufacturer"
means a person, other than a pharmacist or prescriber, who
manufactures dangerous drugs and who is engaged in the sale of those
dangerous drugs.
(Q)
"Terminal distributor of dangerous drugs" or "terminal
distributor" means a person who is engaged in the sale of
dangerous drugs at retail, or any person, other than a manufacturer,
repackager, outsourcing facility, third-party logistics provider,
wholesale distributor, or pharmacist, who has possession, custody, or
control of dangerous drugs for any purpose other than for that
person's own use and consumption. "Terminal distributor"
includes pharmacies, hospitals, nursing homes, and laboratories and
all other persons who procure dangerous drugs for sale or other
distribution by or under the supervision of a pharmacist, licensed
health professional authorized to prescribe drugs, or other person
authorized by the state board of pharmacy.
(R)
"Promote to the public" means disseminating a
representation to the public in any manner or by any means, other
than by labeling, for the purpose of inducing, or that is likely to
induce, directly or indirectly, the purchase of a dangerous drug at
retail.
(S)
"Person" includes any individual, partnership, association,
limited liability company, or corporation, the state, any political
subdivision of the state, and any district, department, or agency of
the state or its political subdivisions.
(T)(1)
"Animal shelter" means a facility operated by a humane
society or any society organized under Chapter 1717. of the Revised
Code or a dog pound operated pursuant to Chapter 955. of the Revised
Code.
(2)
"County dog warden" means a dog warden or deputy dog warden
appointed or employed under section 955.12 of the Revised Code.
(U)
"Food" has the same meaning as in section 3715.01 of the
Revised Code.
(V)
"Pain management clinic" has the same meaning as in section
4731.054 of the Revised Code.
(W)
"Investigational drug or product" means a drug or product
that has successfully completed phase one of the United States food
and drug administration clinical trials and remains under clinical
trial, but has not been approved for general use by the United States
food and drug administration. "Investigational drug or product"
does not include controlled substances in schedule I, as defined in
section 3719.01 of the Revised Code.
(X)
"Product," when used in reference to an investigational
drug or product, means a biological product, other than a drug, that
is made from a natural human, animal, or microorganism source and is
intended to treat a disease or medical condition.
(Y)
"Third-party logistics provider" means a person that
provides or coordinates warehousing or other logistics services
pertaining to dangerous drugs including distribution, on behalf of a
manufacturer, wholesale distributor, or terminal distributor of
dangerous drugs, but does not take ownership of the drugs or have
responsibility to direct the sale or disposition of the drugs.
(Z)
"Repackager of dangerous drugs" or "repackager"
means a person that repacks and relabels dangerous drugs for sale or
distribution.
(AA)
"Outsourcing facility" means a facility that is engaged in
the compounding and sale of sterile drugs and is registered as an
outsourcing facility with the United States food and drug
administration.
(BB)
"Laboratory" means a laboratory licensed under this chapter
as a terminal distributor of dangerous drugs and entrusted to have
custody of any of the following drugs and to use the drugs for
scientific and clinical purposes and for purposes of instruction:
dangerous drugs that are not controlled substances, as defined in
section 3719.01 of the Revised Code; dangerous drugs that are
controlled substances, as defined in that section; and controlled
substances in schedule I, as defined in that section.
(CC)
"Overdose reversal drug" means both of the following:
(1)
Naloxone;
(2)
Any other drug that the state board of pharmacy, through rules
adopted in accordance with Chapter 119. of the Revised Code,
designates as a drug that is approved by the federal food and drug
administration for the reversal of a known or suspected
opioid-related overdose.
Sec.
4729.51.
(A)
No person other than a licensed manufacturer of dangerous drugs,
outsourcing facility, third-party logistics provider, repackager of
dangerous drugs, or wholesale distributor of dangerous drugs shall
possess for sale, sell, distribute, or deliver, at wholesale,
dangerous drugs or investigational drugs or products, except as
follows:
(1)
A licensed terminal distributor of dangerous drugs that is a pharmacy
may make occasional sales of dangerous drugs or investigational drugs
or products at wholesale.
(2)
A licensed terminal distributor of dangerous drugs having more than
one licensed location may transfer or deliver dangerous drugs from
one licensed location to another licensed location owned by the
terminal distributor if the license issued for each location is in
effect at the time of the transfer or delivery.
(3)
A licensed terminal distributor of dangerous drugs that is not a
pharmacy may make occasional sales of the following at wholesale:
(a)
Overdose reversal drugs;
(b)
Dangerous drugs if the drugs being sold are in shortage, as defined
in rules adopted under section 4729.26 of the Revised Code;
(c)
Dangerous drugs other than those described in divisions (A)(3)(a) and
(b) of this section or investigational drugs or products if
authorized by rules adopted under section 4729.26 of the Revised
Code.
(B)
No licensed manufacturer, outsourcing facility, third-party logistics
provider, repackager, or wholesale distributor shall possess for
sale, sell, or distribute, at wholesale, dangerous drugs or
investigational drugs or products to any person other than the
following:
(1)
Subject to division (D) of this section, a licensed terminal
distributor of dangerous drugs;
(2)
Subject to division (C) of this section, any person exempt from
licensure as a terminal distributor of dangerous drugs under section
4729.541 of the Revised Code;
(3)
A licensed manufacturer, outsourcing facility, third-party logistics
provider, repackager, or wholesale distributor;
(4)
A terminal distributor, manufacturer, outsourcing facility,
third-party logistics provider, repackager, or wholesale distributor
that is located in another state, is not engaged in the sale of
dangerous drugs within this state, and is actively licensed to engage
in the sale of dangerous drugs by the state in which the distributor
conducts business.
(C)
No licensed manufacturer, outsourcing facility, third-party logistics
provider, repackager, or wholesale distributor shall possess for
sale, sell, or distribute, at wholesale, dangerous drugs or
investigational drugs or products to either of the following:
(1)
A prescriber who is employed by a pain management clinic that is not
licensed as a terminal distributor of dangerous drugs with a pain
management clinic classification issued under section 4729.552 of the
Revised Code;
(2)
A business entity described in division (A)(2) or (3) of section
4729.541 of the Revised Code that is, or is operating, a pain
management clinic without a license as a terminal distributor of
dangerous drugs with a pain management clinic classification issued
under section 4729.552 of the Revised Code.
(D)
No licensed manufacturer, outsourcing facility, third-party logistics
provider, repackager, or wholesale distributor shall possess
dangerous drugs or investigational drugs or products for sale at
wholesale, or sell or distribute such drugs at wholesale, to a
licensed terminal distributor of dangerous drugs, except as follows:
(1)
In the case of a terminal distributor with a category II license,
only dangerous drugs in category II, as defined in division (A)(1) of
section 4729.54 of the Revised Code;
(2)
In the case of a terminal distributor with a category III license,
dangerous drugs in category II and category III, as defined in
divisions (A)(1) and (2) of section 4729.54 of the Revised Code;
(3)
In the case of a terminal distributor with a limited category II or
III license, only the dangerous drugs specified in the license.
(E)(1)
Except as provided in division (E)(2) of this section, no person
shall do any of the following:
(a)
Sell or distribute, at retail, dangerous drugs;
(b)
Possess for sale, at retail, dangerous drugs;
(c)
Possess dangerous drugs.
(2)(a)
Divisions (E)(1)(a), (b), and (c) of this section do not apply to any
of the following:
(i)
A licensed terminal distributor of dangerous drugs;
(ii)
A person who possesses, or possesses for sale or sells, at retail, a
dangerous drug in accordance with Chapters 3719., 4715., 4723.,
4725., 4729., 4730., 4731., 4741.,
4761.,
and
4772. of the Revised Code;
(iii)
Any of the persons identified in divisions (A)(1) to (5) and
(18)
(17)
of section 4729.541 of the Revised Code, but only to the extent
specified in that section.
(b)
Division (E)(1)(c) of this section does not apply to any of the
following:
(i)
A licensed manufacturer, outsourcing facility, third-party logistics
provider, repackager, or wholesale distributor;
(ii)
Any of the persons identified in divisions (A)(6) to (16) of section
4729.541 of the Revised Code, but only to the extent specified in
that section.
(F)
No licensed terminal distributor of dangerous drugs or person that is
exempt from licensure under section 4729.541 of the Revised Code
shall purchase dangerous drugs or investigational drugs or products
from any person other than a licensed manufacturer, outsourcing
facility, third-party logistics provider, repackager, or wholesale
distributor, except as follows:
(1)
A licensed terminal distributor of dangerous drugs or person that is
exempt from licensure under section 4729.541 of the Revised Code may
make occasional purchases of dangerous drugs or investigational drugs
or products that are sold in accordance with division (A)(1) or (3)
of this section.
(2)
A licensed terminal distributor of dangerous drugs having more than
one licensed location may transfer or deliver dangerous drugs or
investigational drugs or products from one licensed location to
another licensed location if the license issued for each location is
in effect at the time of the transfer or delivery.
(G)
No licensed terminal distributor of dangerous drugs shall engage in
the retail sale or other distribution of dangerous drugs or
investigational drugs or products or maintain possession, custody, or
control of dangerous drugs or investigational drugs or products for
any purpose other than the distributor's personal use or consumption,
at any establishment or place other than that or those described in
the license issued by the state board of pharmacy to such terminal
distributor.
(H)
Nothing in this section shall be construed to interfere with the
performance of official duties by any law enforcement official
authorized by municipal, county, state, or federal law to collect
samples of any drug, regardless of its nature or in whose possession
it may be.
(I)
Notwithstanding anything to the contrary in this section, the board
of education of a city, local, exempted village, or joint vocational
school district may distribute epinephrine autoinjectors for use in
accordance with section 3313.7110 of the Revised Code, may distribute
inhalers for use in accordance with section 3313.7113 of the Revised
Code, and may distribute injectable or nasally administered glucagon
for use in accordance with section 3313.7115 of the Revised Code.
Sec.
4731.22.
(A)
The state medical board, by an affirmative vote of not fewer than six
of its members, may limit, revoke, or suspend a license or
certificate to practice or certificate to recommend, refuse to grant
a license or certificate, refuse to renew a license or certificate,
refuse to reinstate a license or certificate, or reprimand or place
on probation the holder of a license or certificate if the individual
applying for or holding the license or certificate is found by the
board to have committed fraud during the administration of the
examination for a license or certificate to practice or to have
committed fraud, misrepresentation, or deception in applying for,
renewing, or securing any license or certificate to practice or
certificate to recommend issued by the board.
(B)
Except as provided in division (P) of this section, the board, by an
affirmative vote of not fewer than six members, shall, to the extent
permitted by law, limit, revoke, or suspend a license or certificate
to practice or certificate to recommend, refuse to issue a license or
certificate, refuse to renew a license or certificate, refuse to
reinstate a license or certificate, or reprimand or place on
probation the holder of a license or certificate for one or more of
the following reasons:
(1)
Permitting one's name or one's license or certificate to practice to
be used by a person, group, or corporation when the individual
concerned is not actually directing the treatment given;
(2)
Failure to maintain minimal standards applicable to the selection or
administration of drugs, or failure to employ acceptable scientific
methods in the selection of drugs or other modalities for treatment
of disease;
(3)
Except as provided in section 4731.97 of the Revised Code, selling,
giving away, personally furnishing, prescribing, or administering
drugs for other than legal and legitimate therapeutic purposes or a
plea of guilty to, a judicial finding of guilt of, or a judicial
finding of eligibility for intervention in lieu of conviction of, a
violation of any federal or state law regulating the possession,
distribution, or use of any drug;
(4)
Willfully betraying a professional confidence.
For
purposes of this division, "willfully betraying a professional
confidence" does not include providing any information,
documents, or reports under sections 307.621 to 307.629 of the
Revised Code to a child fatality review board; does not include
providing any information, documents, or reports under sections
307.631 to 307.6410 of the Revised Code to a drug overdose fatality
review committee, a suicide fatality review committee, or hybrid drug
overdose fatality and suicide fatality review committee; does not
include providing any information, documents, or reports under
sections 307.651 to 307.659 of the Revised Code to a domestic
violence fatality review board; does not include providing any
information, documents, or reports to the director of health pursuant
to guidelines established under section 3701.70 of the Revised Code;
does not include written notice to a mental health professional under
section 4731.62 of the Revised Code; does not include making a report
as described in division (F) of section 2921.22 and section 4731.224
of the Revised Code; and does not include the making of a report of
an employee's use of a drug of abuse, or a report of a condition of
an employee other than one involving the use of a drug of abuse, to
the employer of the employee as described in division (B) of section
2305.33 of the Revised Code. Nothing in this division affects the
immunity from civil liability conferred by section 2305.33 or 4731.62
of the Revised Code upon a physician who makes a report in accordance
with section 2305.33 or notifies a mental health professional in
accordance with section 4731.62 of the Revised Code. As used in this
division, "employee," "employer," and "physician"
have the same meanings as in section 2305.33 of the Revised Code.
(5)
Making a false, fraudulent, deceptive, or misleading statement in the
solicitation of or advertising for patients; in relation to the
practice of medicine and surgery, osteopathic medicine and surgery,
podiatric medicine and surgery, or a limited branch of medicine; or
in securing or attempting to secure any license or certificate to
practice issued by the board.
As
used in this division, "false, fraudulent, deceptive, or
misleading statement" means a statement that includes a
misrepresentation of fact, is likely to mislead or deceive because of
a failure to disclose material facts, is intended or is likely to
create false or unjustified expectations of favorable results, or
includes representations or implications that in reasonable
probability will cause an ordinarily prudent person to misunderstand
or be deceived.
(6)
A departure from, or the failure to conform to, minimal standards of
care of similar practitioners under the same or similar
circumstances, whether or not actual injury to a patient is
established;
(7)
Representing, with the purpose of obtaining compensation or other
advantage as personal gain or for any other person, that an incurable
disease or injury, or other incurable condition, can be permanently
cured;
(8)
The obtaining of, or attempting to obtain, money or anything of value
by fraudulent misrepresentations in the course of practice;
(9)
A plea of guilty to, a judicial finding of guilt of, or a judicial
finding of eligibility for intervention in lieu of conviction for, a
felony;
(10)
Commission of an act that constitutes a felony in this state,
regardless of the jurisdiction in which the act was committed;
(11)
A plea of guilty to, a judicial finding of guilt of, or a judicial
finding of eligibility for intervention in lieu of conviction for, a
misdemeanor committed in the course of practice;
(12)
Commission of an act in the course of practice that constitutes a
misdemeanor in this state, regardless of the jurisdiction in which
the act was committed;
(13)
A plea of guilty to, a judicial finding of guilt of, or a judicial
finding of eligibility for intervention in lieu of conviction for, a
misdemeanor involving moral turpitude;
(14)
Commission of an act involving moral turpitude that constitutes a
misdemeanor in this state, regardless of the jurisdiction in which
the act was committed;
(15)
Violation of the conditions of limitation placed by the board upon a
license or certificate to practice;
(16)
Failure to pay license renewal fees specified in this chapter;
(17)
Except as authorized in section 4731.31 of the Revised Code, engaging
in the division of fees for referral of patients, or the receiving of
a thing of value in return for a specific referral of a patient to
utilize a particular service or business;
(18)
Subject to section 4731.226 of the Revised Code, violation of any
provision of a code of ethics of the American medical association,
the American osteopathic association, the American podiatric medical
association, or any other national professional organizations that
the board specifies by rule. The state medical board shall obtain and
keep on file current copies of the codes of ethics of the various
national professional organizations. The individual whose license or
certificate is being suspended or revoked shall not be found to have
violated any provision of a code of ethics of an organization not
appropriate to the individual's profession.
For
purposes of this division, a "provision of a code of ethics of a
national professional organization" does not include any
provision that would preclude the making of a report by a physician
of an employee's use of a drug of abuse, or of a condition of an
employee other than one involving the use of a drug of abuse, to the
employer of the employee as described in division (B) of section
2305.33 of the Revised Code. Nothing in this division affects the
immunity from civil liability conferred by that section upon a
physician who makes either type of report in accordance with division
(B) of that section. As used in this division, "employee,"
"employer," and "physician" have the same
meanings as in section 2305.33 of the Revised Code.
(19)
Inability to practice according to acceptable and prevailing
standards of care by reason of mental illness or physical illness,
including, but not limited to, physical deterioration that adversely
affects cognitive, motor, or perceptive skills.
In
enforcing this division, the board, upon a showing of a possible
violation, shall refer any individual who is authorized to practice
by this chapter or who has submitted an application pursuant to this
chapter to the monitoring organization that conducts the confidential
monitoring program established under section 4731.25 of the Revised
Code. The board also may compel the individual to submit to a mental
examination, physical examination, including an HIV test, or both a
mental and a physical examination. The expense of the examination is
the responsibility of the individual compelled to be examined.
Failure to submit to a mental or physical examination or consent to
an HIV test ordered by the board constitutes an admission of the
allegations against the individual unless the failure is due to
circumstances beyond the individual's control, and a default and
final order may be entered without the taking of testimony or
presentation of evidence. If the board finds an individual unable to
practice because of the reasons set forth in this division, the board
shall require the individual to submit to care, counseling, or
treatment by physicians approved or designated by the board, as a
condition for initial, continued, reinstated, or renewed authority to
practice. An individual affected under this division shall be
afforded an opportunity to demonstrate to the board the ability to
resume practice in compliance with acceptable and prevailing
standards under the provisions of the individual's license or
certificate. For the purpose of this division, any individual who
applies for or receives a license or certificate to practice under
this chapter accepts the privilege of practicing in this state and,
by so doing, shall be deemed to have given consent to submit to a
mental or physical examination when directed to do so in writing by
the board, and to have waived all objections to the admissibility of
testimony or examination reports that constitute a privileged
communication.
(20)
Except as provided in division (F)(1)(b) of section 4731.282 of the
Revised Code or when civil penalties are imposed under section
4731.225 of the Revised Code, and subject to section 4731.226 of the
Revised Code, violating or attempting to violate, directly or
indirectly, or assisting in or abetting the violation of, or
conspiring to violate, any provisions of this chapter or any rule
promulgated by the board.
This
division does not apply to a violation or attempted violation of,
assisting in or abetting the violation of, or a conspiracy to
violate, any provision of this chapter or any rule adopted by the
board that would preclude the making of a report by a physician of an
employee's use of a drug of abuse, or of a condition of an employee
other than one involving the use of a drug of abuse, to the employer
of the employee as described in division (B) of section 2305.33 of
the Revised Code. Nothing in this division affects the immunity from
civil liability conferred by that section upon a physician who makes
either type of report in accordance with division (B) of that
section. As used in this division, "employee," "employer,"
and "physician" have the same meanings as in section
2305.33 of the Revised Code.
(21)
The violation of section 3701.79 of the Revised Code or of any
abortion rule adopted by the director of health pursuant to section
3701.341 of the Revised Code;
(22)
Any of the following actions taken by an agency responsible for
authorizing, certifying, or regulating an individual to practice a
health care occupation or provide health care services in this state
or another jurisdiction, for any reason other than the nonpayment of
fees: the limitation, revocation, or suspension of an individual's
license to practice; acceptance of an individual's license surrender;
denial of a license; refusal to renew or reinstate a license;
imposition of probation; or issuance of an order of censure or other
reprimand;
(23)
The violation of section 2919.12 of the Revised Code or the
performance or inducement of an abortion upon a pregnant woman with
actual knowledge that the conditions specified in division (B) of
section 2317.56 of the Revised Code have not been satisfied or with a
heedless indifference as to whether those conditions have been
satisfied, unless an affirmative defense as specified in division
(H)(2) of that section would apply in a civil action authorized by
division (H)(1) of that section;
(24)
The revocation, suspension, restriction, reduction, or termination of
clinical privileges by the United States department of defense or
department of veterans affairs or the termination or suspension of a
certificate of registration to prescribe drugs by the drug
enforcement administration of the United States department of
justice;
(25)
Termination or suspension from participation in the medicare or
medicaid programs by the department of health and human services or
other responsible agency;
(26)
Impairment of ability to practice according to acceptable and
prevailing standards of care because of substance use disorder or
excessive use or abuse of drugs, alcohol, or other substances that
may impair ability to practice.
For
the purposes of this division, any individual authorized to practice
by this chapter accepts the privilege of practicing in this state
subject to supervision by the board. By filing an application for or
holding a license or certificate to practice under this chapter, an
individual shall be deemed to have given consent to submit to a
mental or physical examination when ordered to do so by the board in
writing, and to have waived all objections to the admissibility of
testimony or examination reports that constitute privileged
communications.
If
it has reason to believe that any individual authorized to practice
by this chapter or any applicant for licensure or certification to
practice suffers such impairment, the board shall refer the
individual to the monitoring organization that conducts the
confidential monitoring program established under section 4731.25 of
the Revised Code. The board also may compel the individual to submit
to a mental or physical examination, or both. The expense of the
examination is the responsibility of the individual compelled to be
examined. Any mental or physical examination required under this
division shall be undertaken by a treatment provider or physician who
is qualified to conduct the examination and who is approved under
section 4731.251 of the Revised Code.
Failure
to submit to a mental or physical examination ordered by the board
constitutes an admission of the allegations against the individual
unless the failure is due to circumstances beyond the individual's
control, and a default and final order may be entered without the
taking of testimony or presentation of evidence. If the board
determines that the individual's ability to practice is impaired, the
board shall suspend the individual's license or certificate or deny
the individual's application and shall require the individual, as a
condition for initial, continued, reinstated, or renewed licensure or
certification to practice, to submit to treatment.
Before
being eligible to apply for reinstatement of a license or certificate
suspended under this division, the impaired practitioner shall
demonstrate to the board the ability to resume practice in compliance
with acceptable and prevailing standards of care under the provisions
of the practitioner's license or certificate. The demonstration shall
include, but shall not be limited to, the following:
(a)
Certification from a treatment provider approved under section
4731.251 of the Revised Code that the individual has successfully
completed any required inpatient treatment;
(b)
Evidence of continuing full compliance with an aftercare contract or
consent agreement;
(c)
Two written reports indicating that the individual's ability to
practice has been assessed and that the individual has been found
capable of practicing according to acceptable and prevailing
standards of care. The reports shall be made by individuals or
providers approved by the board for making the assessments and shall
describe the basis for their determination.
The
board may reinstate a license or certificate suspended under this
division after that demonstration and after the individual has
entered into a written consent agreement.
When
the impaired practitioner resumes practice, the board shall require
continued monitoring of the individual. The monitoring shall include,
but not be limited to, compliance with the written consent agreement
entered into before reinstatement or with conditions imposed by board
order after a hearing, and, upon termination of the consent
agreement, submission to the board for at least two years of annual
written progress reports made under penalty of perjury stating
whether the individual has maintained sobriety.
(27)
A second or subsequent violation of section 4731.66 or 4731.69 of the
Revised Code;
(28)
Except as provided in division (N) of this section:
(a)
Waiving the payment of all or any part of a deductible or copayment
that a patient, pursuant to a health insurance or health care policy,
contract, or plan that covers the individual's services, otherwise
would be required to pay if the waiver is used as an enticement to a
patient or group of patients to receive health care services from
that individual;
(b)
Advertising that the individual will waive the payment of all or any
part of a deductible or copayment that a patient, pursuant to a
health insurance or health care policy, contract, or plan that covers
the individual's services, otherwise would be required to pay.
(29)
Failure to use universal blood and body fluid precautions established
by rules adopted under section 4731.051 of the Revised Code;
(30)
Failure to provide notice to, and receive acknowledgment of the
notice from, a patient when required by section 4731.143 of the
Revised Code prior to providing nonemergency professional services,
or failure to maintain that notice in the patient's medical record;
(31)
Failure of a physician supervising a physician assistant to maintain
supervision in accordance with the requirements of Chapter 4730. of
the Revised Code and the rules adopted under that chapter;
(32)
Failure of a physician or podiatrist to enter into a standard care
arrangement with a clinical nurse specialist, certified
nurse-midwife, or certified nurse practitioner with whom the
physician or podiatrist is in collaboration pursuant to section
4731.27 of the Revised Code or failure to fulfill the
responsibilities of collaboration after entering into a standard care
arrangement;
(33)
Failure to comply with the terms of a consult agreement entered into
with a pharmacist pursuant to section 4729.39 of the Revised Code;
(34)
Failure to cooperate in an investigation conducted by the board under
division (F) of this section, including failure to comply with a
subpoena or order issued by the board or failure to answer truthfully
a question presented by the board in an investigative interview, an
investigative office conference, at a deposition, or in written
interrogatories, except that failure to cooperate with an
investigation shall not constitute grounds for discipline under this
section if a court of competent jurisdiction has issued an order that
either quashes a subpoena or permits the individual to withhold the
testimony or evidence in issue;
(35)
Failure to supervise an anesthesiologist assistant in accordance with
Chapter 4760. of the Revised Code and the board's rules for
supervision of an anesthesiologist assistant;
(36)
Assisting suicide, as defined in section 3795.01 of the Revised Code;
(37)
Failure to comply with the requirements of section 2317.561 of the
Revised Code;
(38)
Failure to supervise a radiologist assistant in accordance with
Chapter 4774. of the Revised Code and the board's rules for
supervision of radiologist assistants;
(39)
Performing or inducing an abortion at an office or facility with
knowledge that the office or facility fails to post the notice
required under section 3701.791 of the Revised Code;
(40)
Failure to comply with the standards and procedures established in
rules under section 4731.054 of the Revised Code for the operation of
or the provision of care at a pain management clinic;
(41)
Failure to comply with the standards and procedures established in
rules under section 4731.054 of the Revised Code for providing
supervision, direction, and control of individuals at a pain
management clinic;
(42)
Failure to comply with the requirements of section 4729.79 or
4731.055 of the Revised Code, unless the state board of pharmacy no
longer maintains a drug database pursuant to section 4729.75 of the
Revised Code;
(43)
Failure to comply with the requirements of section 2919.171,
2919.202, or 2919.203 of the Revised Code or failure to submit to the
department of health in accordance with a court order a complete
report as described in section 2919.171 or 2919.202 of the Revised
Code;
(44)
Practicing at a facility that is subject to licensure as a category
III terminal distributor of dangerous drugs with a pain management
clinic classification unless the person operating the facility has
obtained and maintains the license with the classification;
(45)
Owning a facility that is subject to licensure as a category III
terminal distributor of dangerous drugs with a pain management clinic
classification unless the facility is licensed with the
classification;
(46)
Failure to comply with any of the requirements regarding making or
maintaining medical records or documents described in division (A) of
section 2919.192, division (C) of section 2919.193, division (B) of
section 2919.195, or division (A) of section 2919.196 of the Revised
Code;
(47)
Failure to comply with the requirements in section 3719.061 of the
Revised Code before issuing for a minor a prescription for an opioid
analgesic, as defined in section 3719.01 of the Revised Code;
(48)
Failure to comply with the requirements of section 4731.30 of the
Revised Code or rules adopted under section 4731.301 of the Revised
Code when recommending treatment with medical marijuana;
(49)
A pattern of continuous or repeated violations of division (E)(2) or
(3) of section 3963.02 of the Revised Code;
(50)
Failure to fulfill the responsibilities of a collaboration agreement
entered into with an athletic trainer as described in section
4755.621 of the Revised Code;
(51)
Failure to take the steps specified in section 4731.911 of the
Revised Code following an abortion or attempted abortion in an
ambulatory surgical facility or other location that is not a hospital
when a child is born alive;
(52)
Violation of section 4731.77 of the Revised Code;
(53)
Failure of a physician supervising a certified mental health
assistant to maintain supervision in accordance with the requirements
of Chapter 4772. of the Revised Code and the rules adopted under that
chapter;
(54)
Failure to comply with the requirements of section 3705.16 of the
Revised Code when certifying a decedent's cause of death and
completing and signing the medical certificate of death
;
(55)
Failure of a physician supervising an advanced practice respiratory
therapist to maintain supervision in accordance with the requirements
of Chapter 4761. of the Revised Code and rules adopted under that
chapter
.
(C)
Disciplinary actions taken by the board under divisions (A) and (B)
of this section shall be taken pursuant to an adjudication under
Chapter 119. of the Revised Code, except that in lieu of an
adjudication, the board may enter into a consent agreement with an
individual to resolve an allegation of a violation of this chapter or
any rule adopted under it. A consent agreement, when ratified by an
affirmative vote of not fewer than six members of the board, shall
constitute the findings and order of the board with respect to the
matter addressed in the agreement. If the board refuses to ratify a
consent agreement, the admissions and findings contained in the
consent agreement shall be of no force or effect.
A
telephone conference call may be utilized for ratification of a
consent agreement that revokes or suspends an individual's license or
certificate to practice or certificate to recommend. The telephone
conference call shall be considered a special meeting under division
(F) of section 121.22 of the Revised Code.
If
the board takes disciplinary action against an individual under
division (B) of this section for a second or subsequent plea of
guilty to, or judicial finding of guilt of, a violation of section
2919.123 or 2919.124 of the Revised Code, the disciplinary action
shall consist of a suspension of the individual's license or
certificate to practice for a period of at least one year or, if
determined appropriate by the board, a more serious sanction
involving the individual's license or certificate to practice. Any
consent agreement entered into under this division with an individual
that pertains to a second or subsequent plea of guilty to, or
judicial finding of guilt of, a violation of that section shall
provide for a suspension of the individual's license or certificate
to practice for a period of at least one year or, if determined
appropriate by the board, a more serious sanction involving the
individual's license or certificate to practice.
(D)
For purposes of divisions (B)(10), (12), and (14) of this section,
the commission of the act may be established by a finding by the
board, pursuant to an adjudication under Chapter 119. of the Revised
Code, that the individual committed the act. The board does not have
jurisdiction under those divisions if the trial court renders a final
judgment in the individual's favor and that judgment is based upon an
adjudication on the merits. The board has jurisdiction under those
divisions if the trial court issues an order of dismissal upon
technical or procedural grounds.
(E)
The sealing or expungement of conviction records by any court shall
have no effect upon a prior board order entered under this section or
upon the board's jurisdiction to take action under this section if,
based upon a plea of guilty, a judicial finding of guilt, or a
judicial finding of eligibility for intervention in lieu of
conviction, the board issued a notice of opportunity for a hearing
prior to the court's order to seal or expunge the records. The board
shall not be required to seal, expunge, destroy, redact, or otherwise
modify its records to reflect the court's sealing of conviction
records.
(F)(1)
The board shall investigate evidence that appears to show that a
person has violated any provision of this chapter or any rule adopted
under it. Any person may report to the board in a signed writing any
information that the person may have that appears to show a violation
of any provision of this chapter or any rule adopted under it. In the
absence of bad faith, any person who reports information of that
nature or who testifies before the board in any adjudication
conducted under Chapter 119. of the Revised Code shall not be liable
in damages in a civil action as a result of the report or testimony.
Each complaint or allegation of a violation received by the board
shall be assigned a case number and shall be recorded by the board.
(2)
Investigations of alleged violations of this chapter or any rule
adopted under it shall be supervised by the supervising member
elected by the board in accordance with section 4731.02 of the
Revised Code and by the secretary as provided in section 4731.39 of
the Revised Code. The president may designate another member of the
board to supervise the investigation in place of the supervising
member. Upon a vote of the majority of the board to authorize the
addition of a consumer member in the supervision of any part of any
investigation, the president shall designate a consumer member for
supervision of investigations as determined by the president. The
authorization of consumer member participation in investigation
supervision may be rescinded by a majority vote of the board. No
member of the board who supervises the investigation of a case shall
participate in further adjudication of the case.
(3)
In investigating a possible violation of this chapter or any rule
adopted under this chapter, or in conducting an inspection under
division (E) of section 4731.054 of the Revised Code, the board may
question witnesses, conduct interviews, administer oaths, order the
taking of depositions, inspect and copy any books, accounts, papers,
records, or documents, issue subpoenas, and compel the attendance of
witnesses and production of books, accounts, papers, records,
documents, and testimony, except that a subpoena for patient record
information shall not be issued without consultation with the
attorney general's office and approval of the secretary of the board.
(a)
Before issuance of a subpoena for patient record information, the
secretary shall determine whether there is probable cause to believe
that the complaint filed alleges a violation of this chapter or any
rule adopted under it and that the records sought are relevant to the
alleged violation and material to the investigation. The subpoena may
apply only to records that cover a reasonable period of time
surrounding the alleged violation.
(b)
On failure to comply with any subpoena issued by the board and after
reasonable notice to the person being subpoenaed, the board may move
for an order compelling the production of persons or records pursuant
to the Rules of Civil Procedure.
(c)
A subpoena issued by the board may be served by a sheriff, the
sheriff's deputy, or a board employee or agent designated by the
board. Service of a subpoena issued by the board may be made by
delivering a copy of the subpoena to the person named therein,
reading it to the person, or leaving it at the person's usual place
of residence, usual place of business, or address on file with the
board. When serving a subpoena to an applicant for or the holder of a
license or certificate issued under this chapter, service of the
subpoena may be made by certified mail, return receipt requested, and
the subpoena shall be deemed served on the date delivery is made or
the date the person refuses to accept delivery. If the person being
served refuses to accept the subpoena or is not located, service may
be made to an attorney who notifies the board that the attorney is
representing the person.
(d)
A sheriff's deputy who serves a subpoena shall receive the same fees
as a sheriff. Each witness who appears before the board in obedience
to a subpoena shall receive the fees and mileage provided for under
section 119.094 of the Revised Code.
(4)
All hearings, investigations, and inspections of the board shall be
considered civil actions for the purposes of section 2305.252 of the
Revised Code.
(5)
A report required to be submitted to the board under this chapter, a
complaint, or information received by the board pursuant to an
investigation or pursuant to an inspection under division (E) of
section 4731.054 of the Revised Code is confidential and not subject
to discovery in any civil action.
The
board shall conduct all investigations or inspections and proceedings
in a manner that protects the confidentiality of patients and persons
who file complaints with the board. The board shall not make public
the names or any other identifying information about patients or
complainants unless proper consent is given or, in the case of a
patient, a waiver of the patient privilege exists under division (B)
of section 2317.02 of the Revised Code, except that consent or a
waiver of that nature is not required if the board possesses reliable
and substantial evidence that no bona fide physician-patient
relationship exists.
The
board may share any information it receives pursuant to an
investigation or inspection, including patient records and patient
record information, with law enforcement agencies, other licensing
boards, and other governmental agencies that are prosecuting,
adjudicating, or investigating alleged violations of statutes or
administrative rules. An agency or board that receives the
information shall comply with the same requirements regarding
confidentiality as those with which the state medical board must
comply, notwithstanding any conflicting provision of the Revised Code
or procedure of the agency or board that applies when it is dealing
with other information in its possession. In a judicial proceeding,
the information may be admitted into evidence only in accordance with
the Rules of Evidence, but the court shall require that appropriate
measures are taken to ensure that confidentiality is maintained with
respect to any part of the information that contains names or other
identifying information about patients or complainants whose
confidentiality was protected by the state medical board when the
information was in the board's possession. Measures to ensure
confidentiality that may be taken by the court include sealing its
records or deleting specific information from its records.
No
person shall knowingly access, use, or disclose confidential
investigatory information in a manner prohibited by law.
(6)
On a quarterly basis, the board shall prepare a report that documents
the disposition of all cases during the preceding three months. The
report shall contain the following information for each case with
which the board has completed its activities:
(a)
The case number assigned to the complaint or alleged violation;
(b)
The type of license or certificate to practice, if any, held by the
individual against whom the complaint is directed;
(c)
A description of the allegations contained in the complaint;
(d)
Whether witnesses were interviewed;
(e)
Whether the individual against whom the complaint is directed is the
subject of any pending complaints;
(f)
The disposition of the case.
The
report shall state how many cases are still pending and shall be
prepared in a manner that protects the identity of each person
involved in each case. The report shall be a public record under
section 149.43 of the Revised Code.
(7)
The board may provide a status update regarding an investigation to a
complainant on request if the board verifies the complainant's
identity.
(G)(1)
If either of the following circumstances occur, the secretary and
supervising member may recommend that the board suspend an
individual's license or certificate to practice or certificate to
recommend without a prior hearing:
(a)
The secretary and supervising member determine both of the following:
(i)
That there is clear and convincing evidence that an individual has
violated division (B) of this section;
(ii)
That the individual's continued practice presents a danger of
immediate and serious harm to the public.
(b)
The board receives verifiable information that a licensee has been
charged in any state or federal court with a crime classified as a
felony under the charging court's law and the conduct constitutes a
violation of division (B) of this section.
(2)
If a recommendation is made to suspend without a prior hearing
pursuant to division (G)(1) of this section, written allegations
shall be prepared for consideration by the board. The board, upon
review of those allegations and by an affirmative vote of not fewer
than six of its members, excluding the secretary and supervising
member, may suspend a license or certificate without a prior hearing.
A telephone conference call may be utilized for reviewing the
allegations and taking the vote on the summary suspension.
The
board shall serve a written order of suspension in accordance with
sections 119.05 and 119.07 of the Revised Code. If the individual
subject to the summary suspension requests an adjudicatory hearing by
the board, the date set for the hearing shall be within fifteen days,
but not earlier than seven days, after the individual requests the
hearing, unless otherwise agreed to by both the board and the
individual.
(3)
Any summary suspension imposed under division (G)(2) of this section
is not a final appealable order and is not an adjudication that may
be appealed under section 119.12 of the Revised Code. The summary
suspension shall remain in effect until a final adjudicative order
issued by the board pursuant to this section and Chapter 119. of the
Revised Code becomes effective. Once a final adjudicative order has
been issued by the board, any party adversely affected by it may file
an appeal in accordance with the requirements of Chapter 119. of the
Revised Code.
The
board shall issue its final adjudicative order within seventy-five
days after completion of its hearing. A failure to issue the order
within seventy-five days shall result in dissolution of the summary
suspension order but shall not invalidate any subsequent, final
adjudicative order.
(H)
If the board takes action under division (B)(9), (11), or (13) of
this section and the judicial finding of guilt, guilty plea, or
judicial finding of eligibility for intervention in lieu of
conviction is overturned on appeal, upon exhaustion of the criminal
appeal, a petition for reconsideration of the order may be filed with
the board along with appropriate court documents. Upon receipt of a
petition of that nature and supporting court documents, the board
shall reinstate the individual's license or certificate to practice.
The board may then hold an adjudication under Chapter 119. of the
Revised Code to determine whether the individual committed the act in
question. Notice of an opportunity for a hearing shall be given in
accordance with Chapter 119. of the Revised Code. If the board finds,
pursuant to an adjudication held under this division, that the
individual committed the act or if no hearing is requested, the board
may order any of the sanctions identified under division (B) of this
section.
(I)
The license or certificate to practice issued to an individual under
this chapter and the individual's practice in this state are
automatically suspended as of the date of the individual's second or
subsequent plea of guilty to, or judicial finding of guilt of, a
violation of section 2919.123 or 2919.124 of the Revised Code. In
addition, the license or certificate to practice or certificate to
recommend issued to an individual under this chapter and the
individual's practice in this state are automatically suspended as of
the date the individual pleads guilty to, is found by a judge or jury
to be guilty of, or is subject to a judicial finding of eligibility
for intervention in lieu of conviction in this state or treatment or
intervention in lieu of conviction in another jurisdiction for any of
the following criminal offenses in this state or a substantially
equivalent criminal offense in another jurisdiction: aggravated
murder, murder, voluntary manslaughter, felonious assault,
trafficking in persons, kidnapping, rape, sexual battery, gross
sexual imposition, aggravated arson, aggravated robbery, or
aggravated burglary. Continued practice after suspension shall be
considered practicing without a license or certificate.
The
board shall notify the individual subject to the suspension in
accordance with sections 119.05 and 119.07 of the Revised Code. If an
individual whose license or certificate is automatically suspended
under this division fails to make a timely request for an
adjudication under Chapter 119. of the Revised Code, the board shall
do whichever of the following is applicable:
(1)
If the automatic suspension under this division is for a second or
subsequent plea of guilty to, or judicial finding of guilt of, a
violation of section 2919.123 or 2919.124 of the Revised Code, the
board shall enter an order suspending the individual's license or
certificate to practice for a period of at least one year or, if
determined appropriate by the board, imposing a more serious sanction
involving the individual's license or certificate to practice.
(2)
In all circumstances in which division (I)(1) of this section does
not apply, enter a final order permanently revoking the individual's
license or certificate to practice.
(J)
If the board is required by Chapter 119. of the Revised Code to give
notice of an opportunity for a hearing and if the individual subject
to the notice does not timely request a hearing in accordance with
section 119.07 of the Revised Code, the board is not required to hold
a hearing, but may adopt, by an affirmative vote of not fewer than
six of its members, a final order that contains the board's findings.
In that final order, the board may order any of the sanctions
identified under division (A) or (B) of this section.
(K)
Any action taken by the board under division (B) of this section
resulting in a suspension from practice shall be accompanied by a
written statement of the conditions under which the individual's
license or certificate to practice may be reinstated. The board shall
adopt rules governing conditions to be imposed for reinstatement.
Reinstatement of a license or certificate suspended pursuant to
division (B) of this section requires an affirmative vote of not
fewer than six members of the board.
(L)
When the board refuses to grant or issue a license or certificate to
practice to an applicant, revokes an individual's license or
certificate to practice, refuses to renew an individual's license or
certificate to practice, or refuses to reinstate an individual's
license or certificate to practice, the board may specify that its
action is permanent. An individual subject to a permanent action
taken by the board is forever thereafter ineligible to hold a license
or certificate to practice and the board shall not accept an
application for reinstatement of the license or certificate or for
issuance of a new license or certificate.
(M)
Notwithstanding any other provision of the Revised Code, all of the
following apply:
(1)
The surrender of a license or certificate issued under this chapter
shall not be effective unless or until accepted by the board. A
telephone conference call may be utilized for acceptance of the
surrender of an individual's license or certificate to practice. The
telephone conference call shall be considered a special meeting under
division (F) of section 121.22 of the Revised Code. Reinstatement of
a license or certificate surrendered to the board requires an
affirmative vote of not fewer than six members of the board.
(2)
An application for a license or certificate made under the provisions
of this chapter may not be withdrawn without approval of the board.
(3)
Failure by an individual to renew a license or certificate to
practice in accordance with this chapter or a certificate to
recommend in accordance with rules adopted under section 4731.301 of
the Revised Code does not remove or limit the board's jurisdiction to
take any disciplinary action under this section against the
individual.
(4)
The placement of an individual's license on retired status, as
described in section 4731.283 of the Revised Code, does not remove or
limit the board's jurisdiction to take any disciplinary action
against the individual with regard to the license as it existed
before being placed on retired status.
(5)
At the request of the board, a license or certificate holder shall
immediately surrender to the board a license or certificate that the
board has suspended, revoked, or permanently revoked.
(N)
Sanctions shall not be imposed under division (B)(28) of this section
against any person who waives deductibles and copayments as follows:
(1)
In compliance with the health benefit plan that expressly allows such
a practice. Waiver of the deductibles or copayments shall be made
only with the full knowledge and consent of the plan purchaser,
payer, and third-party administrator. Documentation of the consent
shall be made available to the board upon request.
(2)
For professional services rendered to any other person authorized to
practice pursuant to this chapter, to the extent allowed by this
chapter and rules adopted by the board.
(O)
Under the board's investigative duties described in this section and
subject to division (F) of this section, the board shall develop and
implement a quality intervention program designed to improve through
remedial education the clinical and communication skills of
individuals authorized under this chapter to practice medicine and
surgery, osteopathic medicine and surgery, and podiatric medicine and
surgery. In developing and implementing the quality intervention
program, the board may do all of the following:
(1)
Offer in appropriate cases as determined by the board an educational
and assessment program pursuant to an investigation the board
conducts under this section;
(2)
Select providers of educational and assessment services, including a
quality intervention program panel of case reviewers;
(3)
Make referrals to educational and assessment service providers and
approve individual educational programs recommended by those
providers. The board shall monitor the progress of each individual
undertaking a recommended individual educational program.
(4)
Determine what constitutes successful completion of an individual
educational program and require further monitoring of the individual
who completed the program or other action that the board determines
to be appropriate;
(5)
Adopt rules in accordance with Chapter 119. of the Revised Code to
further implement the quality intervention program.
An
individual who participates in an individual educational program
pursuant to this division shall pay the financial obligations arising
from that educational program.
(P)
The board shall not refuse to issue a license to an applicant because
of a conviction, plea of guilty, judicial finding of guilt, judicial
finding of eligibility for intervention in lieu of conviction, or the
commission of an act that constitutes a criminal offense, unless the
refusal is in accordance with section 9.79 of the Revised Code.
(Q)
A license or certificate to practice or certificate to recommend
issued to an individual under this chapter and an individual's
practice under this chapter in this state are automatically suspended
if the individual's license or certificate to practice a health care
occupation or provide health care services is suspended, revoked, or
surrendered or relinquished in lieu of discipline by an agency
responsible for authorizing, certifying, or regulating an individual
to practice a health care occupation or provide health care services
in this state or another jurisdiction. The automatic suspension
begins immediately upon entry of the order by the agency and lasts
for ninety days to permit the board to investigate the basis for the
action under this chapter. Continued practice during the automatic
suspension shall be considered practicing without a license or
certificate.
The
board shall notify the individual subject to the automatic suspension
by certified mail or in person in accordance with section 119.07 of
the Revised Code. If an individual subject to an automatic suspension
under this division fails to make a timely request for an
adjudication under Chapter 119. of the Revised Code, the board is not
required to hold a hearing, but may adopt, by an affirmative vote of
not fewer than six of its members, a final order that contains the
board's findings. In that final order, the board may order any of the
sanctions identified under division (A) or (B) of this section.
Sec.
4731.2210.
(A)
As used in this section:
(1)
"Key third party" means an individual closely involved in a
patient's decision-making regarding health care services, including a
patient's spouse or partner, parents, children, siblings, or
guardians. An individual's status as a key third party ceases upon
termination of a practitioner-patient relationship or termination of
the relationship between a patient and the individual.
(2)
"Practitioner" means any of the following:
(a)
An individual authorized under this chapter to practice medicine and
surgery, osteopathic medicine and surgery, podiatric medicine and
surgery, or a limited branch of medicine;
(b)
An individual licensed under Chapter 4730. of the Revised Code to
practice as a physician assistant;
(c)
An individual authorized under Chapter 4759. of the Revised Code to
practice as a dietitian;
(d)
An individual authorized under Chapter 4760. of the Revised Code to
practice as an anesthesiologist assistant;
(e)
An individual authorized under Chapter 4761. of the Revised Code to
practice respiratory care
or as an advanced practice respiratory therapist
;
(f)
An individual authorized under Chapter 4762. of the Revised Code to
practice as an acupuncturist;
(g)
An individual authorized under Chapter 4772. of the Revised Code to
practice as a certified mental health assistant;
(h)
An individual authorized under Chapter 4774. of the Revised Code to
practice as a radiologist assistant;
(i)
An individual licensed under Chapter 4778. of the Revised Code to
practice as a genetic counselor.
(3)
"Sexual misconduct" has the same meaning as in section
4731.224 of the Revised Code.
(B)
Except as provided in division (D) of this section, the state medical
board may require a practitioner that is subject to a probationary
order of the board that involves a circumstance described in division
(C) of this section, to provide to each patient, or to the patient's
guardian or a key third party, a written disclosure signed by the
practitioner that includes all of the following:
(1)
The practitioner's probation status;
(2)
The total length of the probation;
(3)
The probation end date;
(4)
Practice restrictions placed on the practitioner by the board;
(5)
The board's telephone number;
(6)
An explanation of how the patient can find additional information
regarding the probation on the practitioner's profile page on the
board's internet web site.
The
written disclosure, if required by the board, shall be provided
before the patient's first visit following the probationary order of
the board. The practitioner shall obtain a copy of the disclosure
signed by the patient, or the patient's guardian or a key third
party, and maintain the signed copy in the patient's medical record.
The signed copy shall be made available to the board immediately upon
request.
(C)
The written disclosure described in division (B) of this section
applies in both of the following circumstances:
(1)
Issuance by the board of a final order, final adjudicative order
under Chapter 119. of the Revised Code, or a consent agreement that
is ratified by an affirmative vote of not fewer than six members of
the board establishing any of the following:
(a)
Commission of any act of sexual misconduct with a patient or key
third party;
(b)
Drug or alcohol abuse directly resulting in patient harm, or that
impairs the ability of the practitioner to practice safely;
(c)
Criminal conviction directly resulting in harm to patient health;
(d)
Inappropriate prescribing directly resulting in patient harm.
(2)
A statement of issues alleged that the practitioner committed any of
the acts described in divisions (C)(1)(a) through (d) and,
notwithstanding a lack of admission of guilt, a consent agreement
ratified by an affirmative vote of not fewer than six members of the
board includes express acknowledgement that the disclosure
requirements of this section would serve to protect the public
interest.
(D)
Written disclosure as described in this section is not required in
the following circumstances:
(1)
The patient is unconscious or otherwise unable to comprehend the
disclosure and sign it, and a guardian or a key third party is
unavailable to comprehend and sign it;
(2)
The direct patient interaction occurs in an emergency department or
otherwise occurs as an immediate result of a medical emergency;
(3)
The practitioner does not have a direct treatment relationship with
the patient and does not have direct contact or direct communication
with the patient.
(E)
The board shall provide the following information regarding
practitioners on probation and those practicing under probationary
status, in plain view on a practitioner's profile page on the board's
internet web site:
(1)
Formal action documents detailing the citation, reports and
recommendations, board order, and consent agreement;
(2)
The length of the probation and the end date;
(3)
Practice restrictions placed on the practitioner by the board.
(F)
The board shall provide a sample probation disclosure letter on its
internet web site to be used by practitioners to comply with this
section.
Sec.
4731.25.
(A)
As used in this section and in sections 4731.251 to 4731.255 of the
Revised Code:
(1)
"Applicant" means an individual who has applied under
Chapter 4730., 4731., 4759., 4760., 4761., 4762., 4772., 4774., or
4778. of the Revised Code for a license, training or other
certificate, limited permit, or other authority to practice as any
one of the following practitioners: a physician assistant, physician,
podiatrist, limited branch of medicine practitioner, dietitian,
anesthesiologist assistant, respiratory care professional,
advanced
practice respiratory therapist,
acupuncturist,
certified mental health assistant, radiologist assistant, or genetic
counselor. "Applicant" may include an individual who has
been granted authority by the state medical board to practice as one
type of practitioner, but has applied for authority to practice as
another type of practitioner.
(2)
"Impaired" or "impairment" means either or both
of the following:
(a)
Impairment of ability to practice as described in division (B)(5) of
section 4730.25, division (B)(26) of section 4731.22, division
(A)(18) of section 4759.07, division (B)(6) of section 4760.13,
division (A)(18) of section 4761.09, division (B)(6) of section
4762.13, division (B)(6) of section 4772.20, division (B)(6) of
section 4774.13, or division (B)(6) of section 4778.14 of the Revised
Code;
(b)
Inability to practice as described in division (B)(4) of section
4730.25, division (B)(19) of section 4731.22, division (A)(14) of
section 4759.07, division (B)(5) of section 4760.13, division (A)(14)
of section 4761.09, division (B)(5) of section 4762.13, division
(B)(5) of section 4774.13, or division (B)(5) of section 4778.14 of
the Revised Code.
(3)
"Practitioner" means any of the following:
(a)
An individual authorized under this chapter to practice medicine and
surgery, osteopathic medicine and surgery, podiatric medicine and
surgery, or a limited branch of medicine;
(b)
An individual licensed under Chapter 4730. of the Revised Code to
practice as a physician assistant;
(c)
An individual authorized under Chapter 4759. of the Revised Code to
practice as a dietitian;
(d)
An individual authorized under Chapter 4760. of the Revised Code to
practice as an anesthesiologist assistant;
(e)
An individual authorized under Chapter 4761. of the Revised Code to
practice respiratory care
or to practice as an advanced practice respiratory therapist
;
(f)
An individual licensed under Chapter 4762. of the Revised Code to
practice as an acupuncturist;
(g)
An individual licensed under Chapter 4772. of the Revised Code to
practice as a certified mental health assistant;
(h)
An individual licensed under Chapter 4774. of the Revised Code to
practice as a radiologist assistant;
(i)
An individual licensed under Chapter 4778. of the Revised Code to
practice as a genetic counselor.
(B)
The state medical board shall establish a confidential,
nondisciplinary program for the evaluation and treatment of
practitioners and applicants who are, or may be, impaired and also
meet the eligibility conditions described in section 4731.252 or
4731.253 of the Revised Code. The program shall be known as the
confidential monitoring program.
The
board shall contract with a monitoring organization to conduct the
program and perform monitoring services. To be qualified to contract
with the board, an organization shall meet all of the following
requirements:
(1)
Be a professionals health program sponsored by one or more
professional associations or societies of practitioners;
(2)
Be organized as a not-for-profit entity and exempt from federal
income taxation under subsection 501(c)(3) of the Internal Revenue
Code;
(3)
Contract with or employ a medical director who is authorized under
this chapter to practice medicine and surgery or osteopathic medicine
and surgery and specializes or has training and expertise in
addiction medicine;
(4)
Contract with or employ licensed health care professionals necessary
for the organization's operation.
(C)
The monitoring organization shall do all of the following pursuant to
the contract:
(1)
Receive from the board a referral regarding an applicant or receive
any report of suspected practitioner impairment from any source,
including from the board;
(2)
Notify a practitioner who is the subject of a report received under
division (C)(1) of this section that the report has been made and
that the practitioner may be eligible to participate in the program
conducted under this section;
(3)
Provide a practitioner who is the subject of a report received under
division (C)(1) of this section with the list of approved evaluators
and treatment providers prepared and updated as described in section
4731.251 of the Revised Code;
(4)
Determine whether a practitioner reported or applicant referred to
the monitoring organization is eligible to participate in the
program, which in the case of an applicant may include evaluating
records as described in division (E)(1)(d) of this section, and
notify the practitioner or applicant of the determination;
(5)
In the case of a practitioner reported by a treatment provider,
notify the treatment provider of the eligibility determination;
(6)
Report to the board any practitioner or applicant who is determined
ineligible to participate in the program;
(7)
Refer an eligible practitioner who chooses to participate in the
program for evaluation by an evaluator approved by the monitoring
organization, unless the report received by the monitoring
organization was made by an approved evaluator and the practitioner
has already been evaluated;
(8)
Monitor the evaluation of an eligible practitioner;
(9)
Refer an eligible practitioner who chooses to participate in the
program to a treatment provider approved by the monitoring
organization;
(10)
Establish, in consultation with the treatment provider to which a
practitioner is referred, the terms and conditions with which the
practitioner must comply for continued participation in and
successful completion of the program;
(11)
Report to the board any practitioner who does not complete evaluation
or treatment or does not comply with any of the terms and conditions
established by the monitoring organization and the treatment
provider;
(12)
Perform any other activities specified in the contract with the board
or that the monitoring organization considers necessary to comply
with this section and sections 4731.251 to 4731.255 of the Revised
Code.
(D)
The monitoring organization shall not disclose to the board the name
of a practitioner or applicant or any records relating to a
practitioner or applicant, unless any of the following occurs:
(1)
The practitioner or applicant is determined to be ineligible to
participate in the program.
(2)
The practitioner or applicant requests the disclosure.
(3)
The practitioner or applicant is unwilling or unable to complete or
comply with any part of the program, including evaluation, treatment,
or monitoring.
(4)
The practitioner or applicant presents an imminent danger to oneself
or the public, as a result of the practitioner's or applicant's
impairment.
(5)
The practitioner's impairment has not been substantially alleviated
by participation in the program.
(E)(1)
The monitoring organization shall develop procedures governing each
of the following:
(a)
Receiving reports of practitioner impairment;
(b)
Notifying practitioners of reports and eligibility determinations;
(c)
Receiving applicant referrals as described in section 4731.253 of the
Revised Code;
(d)
Evaluating records of referred applicants, in particular records from
other jurisdictions regarding prior treatment for impairment or
current or continued monitoring;
(e)
Notifying applicants of eligibility determinations;
(f)
Referring eligible practitioners for evaluation or treatment;
(g)
Establishing individualized treatment plans for eligible
practitioners, as recommended by treatment providers;
(h)
Establishing individualized terms and conditions with which eligible
practitioners or applicants must comply for continued participation
in and successful completion of the program.
(2)
The monitoring organization, in consultation with the board, shall
develop procedures governing each of the following:
(a)
Providing reports to the board on a periodic basis on the total
number of practitioners or applicants participating in the program,
without disclosing the names or records of any program participants
other than those about whom reports are required by this section;
(b)
Reporting to the board any practitioner or applicant who due to
impairment presents an imminent danger to oneself or the public;
(c)
Reporting to the board any practitioner or applicant who is unwilling
or unable to complete or comply with any part of the program,
including evaluation, treatment, or monitoring;
(d)
Reporting to the board any practitioner or applicant whose impairment
was not substantially alleviated by participation in the program.
Sec.
4743.09.
(A)
As used in this section:
(1)
"Durable medical equipment" means a type of equipment, such
as a remote monitoring device utilized by a physician, physician
assistant, or advanced practice registered nurse in accordance with
this section, that can withstand repeated use, is primarily and
customarily used to serve a medical purpose, and generally is not
useful to a person in the absence of illness or injury and, in
addition, includes repair and replacement parts for the equipment.
(2)
"Facility fee" means any fee charged or billed for
telehealth services provided in a facility that is intended to
compensate the facility for its operational expenses and is separate
and distinct from a professional fee.
(3)
"Health care professional" means:
(a)
An advanced practice registered nurse, as defined in section 4723.01
of the Revised Code;
(b)
An optometrist licensed under Chapter 4725. of the Revised Code to
practice optometry;
(c)
A pharmacist licensed under Chapter 4729. of the Revised Code;
(d)
A physician assistant licensed under Chapter 4730. of the Revised
Code;
(e)
A physician licensed under Chapter 4731. of the Revised Code to
practice medicine and surgery, osteopathic medicine and surgery, or
podiatric medicine and surgery;
(f)
A psychologist, independent school psychologist, or school
psychologist licensed under Chapter 4732. of the Revised Code;
(g)
A chiropractor licensed under Chapter 4734. of the Revised Code;
(h)
An audiologist or speech-language pathologist licensed under Chapter
4753. of the Revised Code;
(i)
An occupational therapist or physical therapist licensed under
Chapter 4755. of the Revised Code;
(j)
An occupational therapy assistant or physical therapist assistant
licensed under Chapter 4755. of the Revised Code;
(k)
A professional clinical counselor, independent social worker,
independent marriage and family therapist, art therapist, or music
therapist licensed under Chapter 4757. of the Revised Code;
(l)
An independent chemical dependency counselor licensed under Chapter
4758. of the Revised Code;
(m)
A dietitian licensed under Chapter 4759. of the Revised Code;
(n)
A respiratory care professional
or
advanced practice respiratory therapist
licensed
under Chapter 4761. of the Revised Code;
(o)
A genetic counselor licensed under Chapter 4778. of the Revised Code;
(p)
A certified Ohio behavior analyst certified under Chapter 4783. of
the Revised Code;
(q)
A certified mental health assistant licensed under Chapter 4772. of
the Revised Code.
(4)
"Health care professional licensing board" means any of the
following:
(a)
The board of nursing;
(b)
The state vision professionals board;
(c)
The state board of pharmacy;
(d)
The state medical board;
(e)
The state board of psychology;
(f)
The state chiropractic board;
(g)
The state speech and hearing professionals board;
(h)
The Ohio occupational therapy, physical therapy, and athletic
trainers board;
(i)
The counselor, social worker, and marriage and family therapist
board;
(j)
The chemical dependency professionals board.
(5)
"Health plan issuer" has the same meaning as in section
3922.01 of the Revised Code.
(6)
"Telehealth services" means health care services provided
through the use of information and communication technology by a
health care professional, within the professional's scope of
practice, who is located at a site other than the site where either
of the following is located:
(a)
The patient receiving the services;
(b)
Another health care professional with whom the provider of the
services is consulting regarding the patient.
(B)(1)
Each health care professional licensing board shall permit a health
care professional under its jurisdiction to provide the
professional's services as telehealth services in accordance with
this section. Subject to division (B)(2) of this section, a board may
adopt any rules it considers necessary to implement this section. All
rules adopted under this section shall be adopted in accordance with
Chapter 119. of the Revised Code. Any such rules adopted by a board
are not subject to the requirements of division (F) of section 121.95
of the Revised Code.
(2)(a)
Except as provided in division (B)(2)(b) of this section, the rules
adopted by a health care professional licensing board under this
section shall establish a standard of care for telehealth services
that is equal to the standard of care for in-person services.
(b)
Subject to division (B)(2)(c) of this section, a board may require an
initial in-person visit prior to prescribing a schedule II controlled
substance to a new patient, equivalent to applicable state and
federal requirements.
(c)(i)
A board shall not require an initial in-person visit for a new
patient whose medical record indicates that the patient is receiving
hospice or palliative care, who is receiving medication-assisted
treatment or any other medication for opioid-use disorder, who is a
patient with a mental health condition, or who, as determined by the
clinical judgment of a health care professional, is in an emergency
situation.
(ii)
Notwithstanding division (B) of section 3796.01 of the Revised Code,
medical marijuana shall not be considered a schedule II controlled
substance.
(C)
With respect to the provision of telehealth services, all of the
following apply:
(1)
A health care professional may use synchronous or asynchronous
technology to provide telehealth services to a patient during an
initial visit if the appropriate standard of care for an initial
visit is satisfied.
(2)
A health care professional may deny a patient telehealth services
and, instead, require the patient to undergo an in-person visit.
(3)
When providing telehealth services in accordance with this section, a
health care professional shall comply with all requirements under
state and federal law regarding the protection of patient
information. A health care professional shall ensure that any
username or password information and any electronic communications
between the professional and a patient are securely transmitted and
stored.
(4)
A health care professional may use synchronous or asynchronous
technology to provide telehealth services to a patient during an
annual visit if the appropriate standard of care for an annual visit
is satisfied.
(5)
In the case of a health care professional who is a physician,
physician assistant, or advanced practice registered nurse, both of
the following apply:
(a)
The professional may provide telehealth services to a patient located
outside of this state if permitted by the laws of the state in which
the patient is located.
(b)
The professional may provide telehealth services through the use of
medical devices that enable remote monitoring, including such
activities as monitoring a patient's blood pressure, heart rate, or
glucose level.
(D)
When a patient has consented to receiving telehealth services, the
health care professional who provides those services is not liable in
damages under any claim made on the basis that the services do not
meet the same standard of care that would apply if the services were
provided in-person.
(E)(1)
A health care professional providing telehealth services shall not
charge a patient or a health plan issuer covering telehealth services
under section 3902.30 of the Revised Code any of the following: a
facility fee, an origination fee, or any fee associated with the cost
of the equipment used at the provider site to provide telehealth
services.
A
health care professional providing telehealth services may charge a
health plan issuer for durable medical equipment used at a patient or
client site.
(2)
A health care professional may negotiate with a health plan issuer to
establish a reimbursement rate for fees associated with the
administrative costs incurred in providing telehealth services as
long as a patient is not responsible for any portion of the fee.
(3)
A health care professional providing telehealth services shall obtain
a patient's consent before billing for the cost of providing the
services, but the requirement to do so applies only once.
(F)
Nothing in this section limits or otherwise affects any other
provision of the Revised Code that requires a health care
professional who is not a physician to practice under the supervision
of, in collaboration with, in consultation with, or pursuant to the
referral of another health care professional.
(G)
It is the intent of the general assembly, through the amendments to
this section, to expand access to and investment in telehealth
services in this state in congruence with the expansion and
investment in telehealth services made during the COVID-19 pandemic.
Sec.
4755.48.
(A)
No person shall employ fraud or deception in applying for or securing
a license to practice physical therapy or to be a physical therapist
assistant.
(B)
No person shall practice or in any way imply or claim to the public
by words, actions, or the use of letters as described in division (C)
of this section to be able to practice physical therapy or to provide
physical therapy services, including practice as a physical therapist
assistant, unless the person holds a valid license under sections
4755.40 to 4755.56 of the Revised Code or except for submission of
claims as provided in section 4755.56 of the Revised Code.
(C)
No person shall use the words or letters, physical therapist,
physical therapy, physical therapy services, physiotherapist,
physiotherapy, physiotherapy services, licensed physical therapist,
P.T., Ph.T., P.T.T., R.P.T., L.P.T., M.P.T., D.P.T., M.S.P.T.,
P.T.A., physical therapy assistant, physical therapist assistant,
physical therapy technician, licensed physical therapist assistant,
L.P.T.A., R.P.T.A., or any other letters, words, abbreviations, or
insignia, indicating or implying that the person is a physical
therapist or physical therapist assistant without a valid license
under sections 4755.40 to 4755.56 of the Revised Code.
(D)
No person who practices physical therapy or assists in the provision
of physical therapy treatments under the supervision of a physical
therapist shall fail to display the person's current license granted
under sections 4755.40 to 4755.56 of the Revised Code in a
conspicuous location in the place where the person spends the major
part of the person's time so engaged.
(E)
Nothing in sections 4755.40 to 4755.56 of the Revised Code shall
affect or interfere with the performance of the duties of any
physical therapist or physical therapist assistant in active service
in the army, navy, coast guard, marine corps, air force, public
health service, or marine hospital service of the United States,
while so serving.
(F)
Nothing in sections 4755.40 to 4755.56 of the Revised Code shall
prevent or restrict the activities or services of a person pursuing a
course of study leading to a degree in physical therapy in an
accredited or approved educational program if the activities or
services constitute a part of a supervised course of study and the
person is designated by a title that clearly indicates the person's
status as a student.
(G)(1)
Subject to division (G)(2) of this section, nothing in sections
4755.40 to 4755.56 of the Revised Code shall prevent or restrict the
activities or services of any person who holds a current,
unrestricted license to practice physical therapy in another state
when that person, pursuant to contract or employment with an athletic
team located in the state in which the person holds the license,
provides physical therapy to any of the following while the team is
traveling to or from or participating in a sporting event in this
state:
(a)
A member of the athletic team;
(b)
A member of the athletic team's coaching, communications, equipment,
or sports medicine staff;
(c)
A member of a band or cheerleading squad accompanying the athletic
team;
(d)
The athletic team's mascot.
(2)
In providing physical therapy pursuant to division (G)(1) of this
section, the person shall not do either of the following:
(a)
Provide physical therapy at a health care facility;
(b)
Provide physical therapy for more than sixty days in a calendar year.
(3)
The limitations described in divisions (G)(1) and (2) of this section
do not apply to a person who is practicing in accordance with the
compact privilege granted by this state through the "Physical
Therapy Licensure Compact" entered into under section 4755.57 of
the Revised Code.
(4)
The physical therapy section of the occupational therapy, physical
therapy, and athletic trainers board shall not require a nonresident
person who holds a license to practice physical therapy in another
state to obtain a license in accordance with Chapter 4796. of the
Revised Code to provide physical therapy services in the manner
described under division (G)(1) of this section.
(H)(1)
Except as provided in division (H)(2) of this section and subject to
division (I) of this section, no person shall practice physical
therapy other than on the prescription of, or the referral of a
patient by, a person who is licensed in this or another state to do
at least one of the following:
(a)
Practice medicine and surgery, chiropractic, dentistry, osteopathic
medicine and surgery, podiatric medicine and surgery;
(b)
Practice as a physician assistant;
(c)
Practice nursing as an advanced practice registered nurse
;
(d)
Practice as an advanced practice respiratory therapist
.
(2)
The prohibition in division (H)(1) of this section on practicing
physical therapy other than on the prescription of, or the referral
of a patient by, any of the persons described in that division does
not apply if either of the following applies to the person:
(a)
The person holds a master's or doctorate degree from a professional
physical therapy program that is accredited by a national physical
therapy accreditation agency approved by the physical therapy section
of the Ohio occupational therapy, physical therapy, and athletic
trainers board.
(b)
On or before December 31, 2004, the person has completed at least two
years of practical experience as a licensed physical therapist.
(I)
To be authorized to prescribe physical therapy or refer a patient to
a physical therapist for physical therapy, a person described in
division (H)(1) of this section must be in good standing with the
relevant licensing board in this state or the state in which the
person is licensed and must act only within the person's scope of
practice.
(J)
In the prosecution of any person for violation of division (B) or (C)
of this section, it is not necessary to allege or prove want of a
valid license to practice physical therapy or to practice as a
physical therapist assistant, but such matters shall be a matter of
defense to be established by the accused.
Sec.
4761.01.
As
used in this chapter:
(A)
"Respiratory care" means rendering or offering to render to
individuals, groups, organizations, or the public any service
involving the evaluation of cardiopulmonary function, the treatment
of cardiopulmonary impairment, the assessment of treatment
effectiveness, and the care of patients with deficiencies and
abnormalities associated with the cardiopulmonary system. The
practice of respiratory care includes:
(1)
Obtaining, analyzing, testing, measuring, and monitoring blood and
gas samples in the determination of cardiopulmonary parameters and
related physiologic data, including flows, pressures, and volumes,
and the use of equipment employed for this purpose;
(2)
Administering, monitoring, recording the results of, and instructing
in the use of medical gases, aerosols, and bronchopulmonary hygiene
techniques, including drainage, aspiration, and sampling, and
applying, maintaining, and instructing in the use of artificial
airways, ventilators, and other life support equipment employed in
the treatment of cardiopulmonary impairment and provided in
collaboration with other licensed health care professionals
responsible for providing care;
(3)
Performing cardiopulmonary resuscitation and respiratory
rehabilitation techniques;
(4)
Administering medications for the testing or treatment of
cardiopulmonary impairment.
(B)
"Respiratory care professional" means a person who is
licensed under this chapter to practice the full range of services
described in division (A) of this section.
(C)
"Physician" means an individual authorized under Chapter
4731. of the Revised Code to practice medicine and surgery or
osteopathic medicine and surgery.
(D)
"Registered nurse" means an individual licensed under
Chapter 4723. of the Revised Code to engage in the practice of
nursing as a registered nurse.
(E)
"Hospital" has the same meaning as in section 3722.01 of
the Revised Code.
(F)
"Nursing facility" has the same meaning as in section
5165.01 of the Revised Code.
(G)
"Advanced practice registered nurse" has the same meaning
as in section 4723.01 of the Revised Code.
(H)
"Physician assistant" means an individual who holds a valid
license to practice as a physician assistant issued under Chapter
4730. of the Revised Code.
(I)
"Advanced practice respiratory care" means the performance
of services delegated by a supervising physician to an advanced
practice respiratory therapist in the diagnosis and treatment of
patients with cardiopulmonary diseases or conditions, including
prescribing, ordering, and administering drugs and medical devices.
(J)
"Advanced practice respiratory therapist" means an
individual who holds a current, valid license issued under this
chapter that authorizes the practice of advanced practice respiratory
care.
(K)
"Health care facility" means any of the following:
(1)
A hospital;
(2)
Any other hospital-based facility designated by the state medical
board in rules adopted pursuant to division (B) of section 4761.37 of
the Revised Code.
Sec.
4761.03.
(A)
The state medical board shall regulate the practice of respiratory
care in this state and the persons to whom the board issues licenses
and limited permits under this chapter. Rules adopted under this
chapter that deal with the provision of respiratory care in a
hospital, other than rules regulating the issuance of licenses or
limited permits, shall be consistent with the conditions for
participation under medicare, Title XVIII of the "Social
Security Act," 79 Stat. 286 (1965), 42 U.S.C.A. 1395, as
amended, and with the respiratory care accreditation standards of the
joint commission or the American osteopathic association.
(B)
The board shall adopt, and may rescind or amend, rules in accordance
with Chapter 119. of the Revised Code to carry out the purposes of
this chapter, including rules prescribing the following:
(1)
The form and manner for filing applications under sections 4761.05
and 4761.06 of the Revised Code;
(2)
Standards for the approval of examinations and reexaminations
administered by national organizations for licensure, license
renewal, and license reinstatement;
(3)
Standards for the approval of educational programs required to
qualify for licensure and approval of continuing education programs
required for license renewal;
(4)
Continuing education courses and the number of hour requirements
necessary for license renewal under section 4761.06 of the Revised
Code, including rules providing for pro rata reductions by month of
the number of hours of continuing education that must be completed
for license holders who are in their first renewal period, have been
disabled by illness or accident, or have been absent from the
country;
(5)
Procedures for the issuance and renewal of licenses and limited
permits, including the duties that may be fulfilled by the board's
executive director and other board employees;
(6)
Procedures for the limitation, suspension, and revocation of licenses
and limited permits, the refusal to issue, renew, or reinstate
licenses and limited permits, and the imposition of a reprimand or
probation under section 4761.09 of the Revised Code;
(7)
Standards of ethical conduct for the practice of respiratory care;
(8)
The respiratory care tasks that may be performed by an individual
practicing as a polysomnographic technologist pursuant to division
(B)(3) of section 4761.10 of the Revised Code;
(9)
Requirements for criminal records checks of applicants under section
4776.03 of the Revised Code.
(C)
The board shall determine the sufficiency of an applicant's
qualifications for admission to the licensing examination or a
reexamination, and for the issuance or renewal of a license or
limited permit.
(D)
The board shall determine the respiratory care educational programs
that are acceptable for fulfilling the requirements of division (A)
of section 4761.04 of the Revised Code.
(E)(1)
The board shall investigate evidence that appears to show that a
person has violated any provision of this chapter or any rule adopted
under it. Any person may report to the board in a signed writing any
information that the person may have that appears to show a violation
of any provision of this chapter or any rule adopted under it. In the
absence of bad faith, any person who reports information of that
nature or who testifies before the board in any adjudication
conducted under Chapter 119. of the Revised Code shall not be liable
in damages in a civil action as a result of the report or testimony.
Each complaint or allegation of a violation received by the board
shall be assigned a case number and shall be recorded by the board.
(2)
Investigations of alleged violations of this chapter or any rule
adopted under it shall be supervised by the supervising member
elected by the board in accordance with section 4731.02 of the
Revised Code and by the secretary as provided in section 4761.012 of
the Revised Code. The president may designate another member of the
board to supervise the investigation in place of the supervising
member. Upon a vote of the majority of the board to authorize the
addition of a consumer member in the supervision of any part of any
investigation, the president shall designate a consumer member for
supervision of investigations as determined by the president. The
authorization of consumer member participation in investigation
supervision may be rescinded by a majority vote of the board. No
member of the board who supervises the investigation of a case shall
participate in further adjudication of the case.
(3)
In investigating a possible violation of this chapter or any rule
adopted under it, the board may issue subpoenas, administer oaths,
question witnesses, conduct interviews, order the taking of
depositions, inspect and copy any books, accounts, papers, records,
or documents, and compel the attendance of witnesses and production
of books, accounts, papers, records, documents, and testimony, except
that a subpoena for patient record information shall not be issued
without consultation with the attorney general's office and approval
of the secretary of the board.
Before
issuance of a subpoena for patient record information, the secretary
shall determine whether there is probable cause to believe that the
complaint filed alleges a violation of this chapter or any rule
adopted under it and that the records sought are relevant to the
alleged violation and material to the investigation. The subpoena may
apply only to records that cover a reasonable period of time
surrounding the alleged violation.
On
failure to comply with any subpoena issued by the board and after
reasonable notice to the person being subpoenaed, the board may move
for an order compelling the production of persons or records pursuant
to the Rules of Civil Procedure.
A
subpoena issued by the board may be served by a sheriff, the
sheriff's deputy, or a board employee or agent designated by the
board. Service of a subpoena issued by the board may be made by
delivering a copy of the subpoena to the person named therein,
reading it to the person, or leaving it at the person's usual place
of residence, usual place of business, or address on file with the
board. When serving a subpoena to an applicant for or the holder of a
license or limited permit issued under this chapter, service of the
subpoena may be made by certified mail, return receipt requested, and
the subpoena shall be deemed served on the date delivery is made or
the date the person refuses to accept delivery. If the person being
served refuses to accept the subpoena or is not located, service may
be made to an attorney who notifies the board that the attorney is
representing the person.
A
sheriff's deputy who serves a subpoena shall receive the same fees as
a sheriff. Each witness who appears before the board in obedience to
a subpoena shall receive the fees and mileage provided for under
section 119.094 of the Revised Code.
(4)
In
an investigation involving the practice or supervision of an advanced
practice respiratory therapist pursuant to the policies of a health
care facility, the board may require the health care facility to
provide any information the board considers necessary to identify
either or both of the following:
(a)
The facility's policies for the practice of advanced practice
respiratory therapists within the facility;
(b)
The services that the facility has authorized a particular advanced
practice respiratory therapist to provide for the facility.
(5)
All
hearings, investigations, and inspections of the board shall be
considered civil actions for the purposes of section 2305.252 of the
Revised Code.
(5)
(6)
A report required to be submitted to the board under this chapter, a
complaint, or information received by the board pursuant to an
investigation is confidential and not subject to discovery in any
civil action.
The
board shall conduct all investigations or inspections and proceedings
in a manner that protects the confidentiality of patients and persons
who file complaints with the board. The board shall not make public
the names or any other identifying information about patients or
complainants unless proper consent is given.
The
board may share any information it receives pursuant to an
investigation or inspection, including patient records and patient
record information, with law enforcement agencies, other licensing
boards, and other governmental agencies that are prosecuting,
adjudicating, or investigating alleged violations of statutes or
administrative rules. An agency or board that receives the
information shall comply with the same requirements regarding
confidentiality as those with which the state medical board must
comply, notwithstanding any conflicting provision of the Revised Code
or procedure of the agency or board that applies when it is dealing
with other information in its possession. In a judicial proceeding,
the information may be admitted into evidence only in accordance with
the Rules of Evidence, but the court shall require that appropriate
measures are taken to ensure that confidentiality is maintained with
respect to any part of the information that contains names or other
identifying information about patients or complainants whose
confidentiality was protected by the state medical board when the
information was in the board's possession. Measures to ensure
confidentiality that may be taken by the court include sealing its
records or deleting specific information from its records.
No
person shall knowingly access, use, or disclose confidential
investigatory information in a manner prohibited by law.
(6)
(7)
On a quarterly basis, the board shall prepare a report that documents
the disposition of all cases during the preceding three months. The
report shall contain the following information for each case with
which the board has completed its activities:
(a)
The case number assigned to the complaint or alleged violation;
(b)
The type of license or limited permit, if any, held by the individual
against whom the complaint is directed;
(c)
A description of the allegations contained in the complaint;
(d)
Whether witnesses were interviewed;
(e)
Whether the individual against whom the complaint is directed is the
subject of any pending complaints;
(f)
The disposition of the case.
The
report shall state how many cases are still pending and shall be
prepared in a manner that protects the identity of each person
involved in each case. The report shall be a public record under
section 149.43 of the Revised Code.
(7)
(8)
The board may provide a status update regarding an investigation to a
complainant on request if the board verifies the complainant's
identity.
(F)
The board shall keep records of its proceedings and do other things
as are necessary and proper to carry out and enforce the provisions
of this chapter.
(G)
The board shall maintain and publish on its internet web site all of
the following:
(1)
The requirements for the issuance of licenses and limited permits
under this chapter and rules adopted by the board;
(2)
A list of the names and locations of the institutions that each year
granted degrees or certificates of completion in respiratory care.
Sec.
4761.032.
(A)
The state medical board shall appoint a respiratory care advisory
council for the purpose of advising the board on issues relating to
the practice of respiratory care. The advisory council shall consist
of not more than
seven
nine
individuals
knowledgeable in the area of respiratory care.
A
majority of the council members shall be individuals licensed under
this chapter who are actively engaged in the practice of respiratory
care. The board shall include all of the following on the council:
(1)
One physician who is a member of the state medical board;
(2)
One physician who has clinical training and experience in pulmonary
disease
;
and one physician who is a supervising physician of an advanced
practice respiratory therapist.
The
Ohio state medical association, or its successor organization, may
nominate not more than three individuals for consideration by the
board in appointing the physician members described in division
(A)(2) of this section.
(3)
One
advanced practice respiratory therapist;
(4)
One
individual who is not affiliated with any health care profession, who
shall be appointed to represent the interest of consumers
.
The
Ohio society for respiratory care, or its successor organization, may
nominate not more than three individuals for consideration by the
board in appointing any member of the council other than the members
described in divisions (A)(1) and (2) of this section
.
The
Ohio state medical association, or its successor organization, may
nominate not more than three individuals for consideration by the
board in appointing the physician member described in division (A)(2)
of this section.
The
Ohio society for respiratory care, or its successor organization, may
nominate not more than three individuals for consideration by the
board in appointing any member of the council other than the
physician members described in divisions (A)(1) and (2) of this
section.
(B)
Not later than ninety days after January 21, 2018, the board shall
make initial appointments to the council. Initial members shall serve
terms of office of one, two, or three years, as selected by the
board. Thereafter, terms of office shall be for three years, with
each term ending on the same day of the same month as the term that
it succeeds. A council member shall continue in office subsequent to
the expiration date of the member's term until a successor is
appointed and takes office, or until a period of sixty days has
elapsed, whichever occurs first. Each council member shall hold
office from the date of appointment until the end of the term for
which the member was appointed.
(C)
Members shall serve without compensation, but shall be reimbursed for
actual and necessary expenses incurred in performing their official
duties.
(D)
The council shall meet at least four times each year and at such
other times as may be necessary to carry out its responsibilities.
(E)
The council may submit to the board recommendations concerning all of
the following:
(1)
Requirements for issuing a license to practice as a respiratory care
professional or as
an
advanced practice respiratory therapist and requirements for issuing
a permit to practice as
a
limited permit holder, including the educational and experience
requirements that must be met to receive the license or permit;
(2)
Existing and proposed rules pertaining to the practice of respiratory
care and
advanced
practice respiratory care, including the supervisory relationship
between advanced practice respiratory therapists and supervising
physicians, and existing and proposed rules that otherwise pertain to
the
administration and enforcement of this chapter;
(3)
Standards for the approval of educational programs required to
qualify for licensure and continuing education programs for licensure
renewal;
(4)
Standards
for the approval of examinations and re-examinations administered by
national organizations for licensure, license renewal, and license
reinstatement;
(5)
Policies
related to the issuance and renewal of licenses and limited permits;
(5)
(6)
Fees
for the issuance and renewal of
a
license to practice respiratory care as a licensee or as a
licenses
and
limited
permit holder
permits
;
(6)
(7)
Standards
of practice and ethical conduct in the practice of respiratory care;
(7)
(8)
The
safe and effective practice of respiratory care, including scope of
practice and minimal standards of care
;
(9)
Any issue the board asks the council to consider
.
(F)
In addition to the matters that are required to be reviewed under
division (E) of this section, the council may review, and may submit
to the board recommendations concerning, quality assurance activities
to be performed by a supervising physician and advanced practice
respiratory therapist under a quality assurance system established
pursuant to division (F) of section 4761.40 of the Revised Code.
(G)
The board may permit meetings of the council to include the use of
interactive videoconferencing, teleconferencing, or both if all of
the following requirements are met:
(1)
The meeting location is open and accessible to the public.
(2)
Each council member is permitted to choose whether the member attends
in person or through the use of the meeting's videoconferencing or
teleconferencing.
(3)
Any meeting-related materials available before the meeting are sent
to each council member by electronic mail, facsimile, or United
States mail, or are hand-delivered.
(4)
If interactive videoconferencing is used, there is a clear video and
audio connection that enables all participants at the meeting
location to see and hear each council member.
(5)
If teleconferencing is used, there is a clear audio connection that
enables all participants at the meeting location to hear each council
member.
(6)
A roll call vote is recorded for each vote taken.
(7)
The meeting minutes specify for each member whether the member
attended by videoconference, teleconference, or in person.
Sec.
4761.033.
In
addition to rules that are specifically required or authorized by
this chapter to be adopted, the state medical board may adopt any
other rules necessary to govern the practice of advanced practice
respiratory therapists, the supervisory relationship between advanced
practice respiratory therapists and supervising physicians, and the
administration and enforcement of this chapter. Rules adopted under
this section shall be adopted in accordance with Chapter 119. of the
Revised Code.
Sec.
4761.06.
(A)
Each license to practice respiratory care shall expire on the date
that is two years after the date of issuance and may be renewed for
additional two-year periods. Each limited permit to practice
respiratory care shall be renewed annually. Each person seeking to
renew a license or limited permit to practice respiratory care shall
apply to the state medical board in a manner prescribed by the board.
Licenses and limited permits shall be renewed in accordance with the
standard renewal procedure of Chapter 4745. of the Revised Code. The
board shall renew a license if the holder pays the license renewal
fee prescribed under section 4761.07 of the Revised Code and
certifies that the holder has completed the continuing education or
reexamination requirements of division (B) of this section.
At
least one month before a license expires, the board shall provide to
the license holder a renewal notice. Failure of any license holder to
receive a notice of renewal from the board shall not excuse the
holder from the requirements contained in this section. Each license
holder shall give notice to the board of a change in the holder's
residence address, business address, or electronic mail address not
later than thirty days after the change occurs.
The
board shall renew a limited permit if the holder pays the limited
permit renewal fee prescribed under section 4761.07 of the Revised
Code and does either of the following:
(1)
If the limited permit was issued on the basis of division (B)(1)(a)
of section 4761.05 of the Revised Code, certifies that the holder is
enrolled and in good standing in an educational program that meets
the requirements of division (A)(1) of section 4761.04 of the Revised
Code or has graduated from such a program;
(2)
If the limited permit was issued on the basis of division (B)(1)(b)
of section 4761.05 of the Revised Code, certifies that the applicant
is employed as a provider of respiratory care under the supervision
of a respiratory care professional.
(B)
On or before the annual renewal date, the holder of a limited permit
issued under division (B)(1)(b) of section 4761.05 of the Revised
Code shall certify to the board that the holder has satisfactorily
completed the number of hours of continuing education required by the
board, which shall not be less than three nor more than ten hours of
continuing education acceptable to the board.
On
Subject
to division (C) of section 4761.33 of the Revised Code, on
or
before the date a license expires, a license holder shall certify to
the board that the license holder has satisfactorily completed the
number of hours of continuing education required by the board, which
shall be not less than six nor more than twenty hours of continuing
education acceptable to the board, or has passed a reexamination in
accordance with the board's renewal requirements.
(C)(1)
A license to practice respiratory care that is not renewed on or
before its expiration date is automatically suspended on its
expiration date. Continued practice after suspension shall be
considered as practicing in violation of section 4761.10 of the
Revised Code.
(2)
If a license has been suspended pursuant to division (C)(1) of this
section for two years or less, it may be reinstated. The board shall
reinstate the license upon the applicant's submission of a complete
renewal application and payment of a reinstatement fee of one hundred
dollars.
If
a license has been suspended pursuant to division (C)(1) of this
section for more than two years, it may be restored. Subject to
section 4761.061 of the Revised Code, the board may restore the
license upon an applicant's submission of a complete restoration
application and a restoration fee of one hundred twenty-five dollars
and compliance with sections 4776.01 to 4776.04 of the Revised Code.
The board shall not restore a license unless the board, in its
discretion, decides that the results of the criminal records check do
not make the applicant ineligible for a license issued pursuant to
division (A) of this section.
(D)(1)
The board may require a random sample of limited permit holders to
submit materials documenting that the holder has completed the number
of hours of continuing education as described in division (B) of this
section.
(2)
The board may require a random sample of license holders to submit
materials documenting that the holder has completed the number of
hours of continuing education as described in division (B) of this
section or has passed a reexamination.
(3)
Division (D)(1) or (2) of this section does not limit the board's
authority to conduct investigations pursuant to section 4731.22 of
the Revised Code.
(E)(1)
If, through a random sample conducted under division (D) of this
section or through any other means, the board finds that an
individual who certified passing the reexamination or completion of
the number of hours and type of continuing education required to
renew, reinstate, or restore a limited permit or license or to
reactivate a license placed on retired status did not pass the
reexamination or complete the requisite continuing education, the
board may do either of the following:
(a)
Take disciplinary action against the individual under section 4761.09
of the Revised Code, impose a civil penalty, or both;
(b)
Permit the individual to agree in writing to pass the reexamination
or complete the continuing education and pay a civil penalty.
(2)
The board's finding in any disciplinary action taken under division
(E)(1)(a) of this section shall be made pursuant to an adjudication
under Chapter 119. of the Revised Code and by an affirmative vote of
not fewer than six of its members.
(3)
A civil penalty imposed under division (E)(1)(a) of this section or
paid under division (E)(1)(b) of this section shall be in an amount
specified by the board of not more than five thousand dollars. The
board shall deposit civil penalties in accordance with section
4731.24 of the Revised Code.
Sec.
4761.061.
(A)
This section applies to all of the following:
(1)
An applicant seeking restoration of a license issued under this
chapter that has been in a suspended or inactive state for any cause
for more than two years;
(2)
An applicant seeking issuance of a license pursuant to this chapter
who for more than two years has not been engaged in the practice of
respiratory care
or
advanced practice respiratory care
as
either of the following:
(a)
An active practitioner;
(b)
A student in an educational program as described in section 4761.04
or
4761.31
of
the Revised Code.
(3)
An applicant seeking to reactivate a license placed on retired
status.
(B)
Before issuing a license to an applicant subject to this section, or
before restoring a license to good standing or reactivating a license
placed on retired status for an applicant subject to this section,
the state medical board may impose terms and conditions including any
one or more of the following:
(1)
Requiring the applicant to pass an oral or written examination, or
both, to determine the applicant's present fitness to resume
practice;
(2)
Requiring the applicant to obtain additional training and to pass an
examination upon completion of such training;
(3)
Requiring an assessment of the applicant's physical skills for
purposes of determining whether the applicant's coordination, fine
motor skills, and dexterity are sufficient for performing evaluations
and procedures in a manner that meets the minimal standards of care;
(4)
Requiring an assessment of the applicant's skills in recognizing and
understanding diseases and conditions;
(5)
Requiring the applicant to undergo a comprehensive physical
examination, which may include an assessment of physical abilities,
evaluation of sensory capabilities, or screening for the presence of
neurological disorders;
(6)
Restricting or limiting the extent, scope, or type of practice of the
applicant.
The
board shall consider the moral background and the activities of the
applicant during the period of suspension, inactivity, or retirement.
The board shall not issue, restore, or reactivate a license under
this section unless the applicant complies with sections 4776.01 to
4776.04 of the Revised Code.
Sec.
4761.07.
(A)
The state medical board shall charge any license applicant or holder
who is to take an examination required under division (A)(2) of
section 4761.04 or a reexamination required under division (B) of
section 4761.06 of the Revised Code for license renewal or under
section 4761.09 of the Revised Code for license reinstatement, a
nonrefundable examination fee, not to exceed the amount necessary to
cover the expense of administering the examination. The license
applicant or holder shall pay the fee at the time of application for
licensure or renewal.
(B)
The board shall establish the following additional nonrefundable fees
and penalty:
(1)
An
For
an
initial
license
to
practice respiratory care, a
fee
of seventy-five dollars;
(2)
A
For
renewal of a license to practice respiratory care, a
biennial
license
renewal
fee of seventy-five dollars;
(3)
A limited permit fee of twenty dollars;
(4)
A limited permit renewal fee of ten dollars;
(5)
For
an initial license to practice as an advanced practice respiratory
therapist, a fee to be determined by the board in an amount not to
exceed one hundred seventy-five dollars;
(6)
For renewal of a license to practice as an advanced practice
respiratory therapist, a biennial renewal fee to be determined by the
board in an amount not to exceed one hundred twenty-five dollars;
(7)
A
duplicate license or limited permit fee of thirty-five dollars;
(6)
(8)
In
the case of a person holding a license issued under this chapter, a
license verification fee of fifty dollars.
(C)
Notwithstanding division (B)(4) of this section, after the third
renewal of a limited permit that meets the exception in division
(B)(3) of section 4761.05 of the Revised Code, the limited permit
renewal fee shall be thirty-five dollars.
(D)
All fees received by the board shall be deposited into the state
treasury to the credit of the state medical board operating fund
pursuant to section 4731.24 of the Revised Code.
Sec.
4761.09.
(A)
The state medical board, by an affirmative vote of not fewer than six
members, shall, except as provided in division (B) of this section,
and to the extent permitted by law, limit, revoke, or suspend an
individual's license or limited permit, refuse to issue a license or
limited permit to an individual, refuse to renew a license or limited
permit, refuse to reinstate a license or limited permit, or reprimand
or place on probation the holder of a license or limited permit for
one or more of the following reasons:
(1)
A plea of guilty to, a judicial finding of guilt of, or a judicial
finding of eligibility for intervention in lieu of conviction for, a
felony;
(2)
Commission of an act that constitutes a felony in this state,
regardless of the jurisdiction in which the act was committed;
(3)
A plea of guilty to, a judicial finding of guilt of, or a judicial
finding of eligibility for intervention in lieu of conviction for, a
misdemeanor committed in the course of practice;
(4)
Commission of an act in the course of practice that constitutes a
misdemeanor in this state, regardless of the jurisdiction in which
the act was committed;
(5)
A plea of guilty to, a judicial finding of guilt of, or a judicial
finding of eligibility for intervention in lieu of conviction for, a
misdemeanor involving moral turpitude;
(6)
Commission of an act involving moral turpitude that constitutes a
misdemeanor in this state, regardless of the jurisdiction in which
the act was committed;
(7)
Except when civil penalties are imposed under section 4761.091 of the
Revised Code, violating or attempting to violate, directly or
indirectly, or assisting in or abetting the violation of, or
conspiring to violate, any provision of this chapter or the rules
adopted by the board;
(8)
Making a false, fraudulent, deceptive, or misleading statement in the
soliciting
or advertising for employment, in connection with any
solicitation
of or
advertising
advertisement
for
patients
;
,
in relation to the practice of respiratory care
;
,
or advanced practice respiratory care,
or in securing or attempting to secure any license or permit issued
by the board under this chapter.
As
used in division (A)(8) of this section, "false, fraudulent,
deceptive, or misleading statement" means a statement that
includes a misrepresentation of fact, is likely to mislead or deceive
because of a failure to disclose material facts, is intended or is
likely to create false or unjustified expectations of favorable
results, or includes representations or implications that in
reasonable probability will cause an ordinarily prudent person to
misunderstand or be deceived.
(9)
Committing fraud during the administration of the examination for a
license to practice or committing fraud, misrepresentation, or
deception in applying for, renewing, or securing any license or
permit issued by the board;
(10)
A departure from, or failure to conform to, minimal standards of care
of similar practitioners under the same or similar circumstances,
whether or not actual injury to a patient is established;
(11)
Violating the standards of ethical conduct adopted by the board, in
the practice of respiratory care
or advanced practice respiratory care
;
(12)
The obtaining of, or attempting to obtain, money or anything of value
by fraudulent misrepresentations in the course of practice;
(13)
Violation of the conditions of limitation placed by the board upon a
license or permit;
(14)
Inability to practice according to acceptable and prevailing
standards of care by reason of mental illness or physical illness,
including physical deterioration that adversely affects cognitive,
motor, or perceptive skills;
(15)
Any of the following actions taken by an agency responsible for
authorizing, certifying, or regulating an individual to practice a
health care occupation or provide health care services in this state
or another jurisdiction, for any reason other than the nonpayment of
fees: the limitation, revocation, or suspension of an individual's
license; acceptance of an individual's license surrender; denial of a
license; refusal to renew or reinstate a license; imposition of
probation; or issuance of an order of censure or other reprimand;
(16)
The revocation, suspension, restriction, reduction, or termination of
practice privileges by the United States department of defense or
department of veterans affairs;
(17)
Termination or suspension from participation in the medicare or
medicaid programs by the department of health and human services or
other responsible agency for any act or acts that also would
constitute a violation of division (A)(10), (12), or (14) of this
section;
(18)
Impairment of ability to practice according to acceptable and
prevailing standards of care because of substance use disorder or
excessive use or abuse of drugs, alcohol, or other substances that
may impair ability to practice;
(19)
Failure to cooperate in an investigation conducted by the board under
division (E) of section 4761.03 of the Revised Code, including
failure to comply with a subpoena or order issued by the board or
failure to answer truthfully a question presented by the board in an
investigative interview, an investigative office conference, at a
deposition, or in written interrogatories, except that failure to
cooperate with an investigation shall not constitute grounds for
discipline under this section if a court of competent jurisdiction
has issued an order that either quashes a subpoena or permits the
individual to withhold the testimony or evidence in issue;
(20)
Practicing in an area of respiratory care
or
advanced practice respiratory care
for
which the person is clearly untrained or incompetent or practicing in
a manner that conflicts with section 4761.17
or
4761.37
of
the Revised Code;
(21)
Employing, directing, or supervising a person who is not authorized
to practice respiratory care under this chapter in the performance of
respiratory care procedures;
(22)
Misrepresenting educational attainments or authorized functions for
the purpose of obtaining some benefit related to the practice of
respiratory care
or advanced practice respiratory care
;
(23)
Assisting suicide as defined in section 3795.01 of the Revised Code;
(24)
Representing, with the purpose of obtaining compensation or other
advantage as personal gain or for any other person, that an incurable
disease or injury, or other incurable condition, can be permanently
cured
;
(25)
Failure to comply with the requirements of this chapter, Chapter
4731. of the Revised Code, or any rules adopted by the board;
(26)
Violating or attempting to violate, directly or indirectly, or
assisting in or abetting the violation of, or conspiring to violate,
any provision of this chapter, Chapter 4731. of the Revised Code, or
the rules adopted by the board;
(27)
Failure to practice in accordance with the supervising physician's
supervision agreement with the advanced practice respiratory
therapist, including the policies of the health care facility in
which the supervising physician and advanced practice respiratory
therapist are practicing;
(28)
Administering drugs for purposes other than those authorized under
this chapter;
(29)
A plea of guilty to, a judicial finding of guilt of, or a judicial
finding of eligibility for intervention in lieu of conviction for
violating any state or federal law regulating the possession,
distribution, or use of any drug, including trafficking in drugs;
(30)
Willfully betraying a professional confidence;
(31)
Failure to use universal blood and body fluid precautions established
by rules adopted under section 4731.051 of the Revised Code;
(32)
Having the individual's qualification to practice advanced practice
respiratory care from an organization that is recognized by the board
expire, lapse, or otherwise fail to be active
.
Disciplinary
actions taken by the board under division (A) of this section shall
be taken pursuant to an adjudication under Chapter 119. of the
Revised Code, except that in lieu of an adjudication, the board may
enter into a consent agreement with an individual to resolve an
allegation of a violation of this chapter or any rule adopted under
it. A consent agreement, when ratified by an affirmative vote of not
fewer than six members of the board, shall constitute the findings
and order of the board with respect to the matter addressed in the
agreement. If the board refuses to ratify a consent agreement, the
admissions and findings contained in the consent agreement shall be
of no effect.
A
telephone conference call may be utilized for ratification of a
consent agreement that revokes or suspends an individual's license or
permit. The telephone conference call shall be considered a special
meeting under division (F) of section 121.22 of the Revised Code.
(B)
The board shall not refuse to issue a license or limited permit to an
applicant because of a plea of guilty to, a judicial finding of guilt
of, or a judicial finding of eligibility for intervention in lieu of
conviction for an offense unless the refusal is in accordance with
section 9.79 of the Revised Code.
(C)
Any action taken by the board under division (A) of this section
resulting in a suspension from practice shall be accompanied by a
written statement of the conditions under which the individual's
license or permit may be reinstated. The board shall adopt rules
governing conditions to be imposed for reinstatement. Reinstatement
of a license or permit suspended pursuant to division (A) of this
section requires an affirmative vote of not fewer than six members of
the board.
(D)
When the board refuses to grant or issue a license or permit to an
applicant, revokes an individual's license or permit, refuses to
renew an individual's license or permit, or refuses to reinstate an
individual's license or permit, the board may specify that its action
is permanent. An individual subject to a permanent action taken by
the board is forever thereafter ineligible to hold a license or
permit and the board shall not accept an application for
reinstatement of the license or permit or for issuance of a new
license or permit.
(E)
If the board is required by Chapter 119. of the Revised Code to give
notice of an opportunity for a hearing and if the individual subject
to the notice does not timely request a hearing in accordance with
section 119.07 of the Revised Code, the board is not required to hold
a hearing, but may adopt, by an affirmative vote of not fewer than
six of its members, a final order that contains the board's findings.
In the final order, the board may order any of the sanctions
identified under division (A) of this section.
(F)
In enforcing division (A)(14) of this section, the board, upon a
showing of a possible violation, shall refer any individual
authorized to practice by this chapter or who has submitted an
application pursuant to this chapter to the monitoring organization
that conducts the confidential monitoring program established under
section 4731.25 of the Revised Code. The board also may compel the
individual to submit to a mental examination, physical examination,
including an HIV test, or both a mental and a physical examination.
The expense of the examination is the responsibility of the
individual compelled to be examined. Failure to submit to a mental or
physical examination or consent to an HIV test ordered by the board
constitutes an admission of the allegations against the individual
unless the failure is due to circumstances beyond the individual's
control, and a default and final order may be entered without the
taking of testimony or presentation of evidence. If the board finds
an individual unable to practice because of the reasons set forth in
division (A)(14) of this section, the board shall require the
individual to submit to care, counseling, or treatment by physicians
approved or designated by the board, as a condition for initial,
continued, reinstated, or renewed authority to practice. An
individual affected under this division shall be afforded an
opportunity to demonstrate to the board the ability to resume
practice in compliance with acceptable and prevailing standards under
the provisions of the individual's license or permit. For the purpose
of division (A)(14) of this section, any individual who applies for
or receives a license or permit to practice under this chapter
accepts the privilege of practicing in this state and, by so doing,
shall be deemed to have given consent to submit to a mental or
physical examination when directed to do so in writing by the board,
and to have waived all objections to the admissibility of testimony
or examination reports that constitute a privileged communication.
(G)
For the purposes of division (A)(18) of this section, any individual
authorized to practice by this chapter accepts the privilege of
practicing in this state subject to supervision by the board. By
filing an application for or holding a license or permit under this
chapter, an individual shall be deemed to have given consent to
submit to a mental or physical examination when ordered to do so by
the board in writing, and to have waived all objections to the
admissibility of testimony or examination reports that constitute
privileged communications.
If
it has reason to believe that any individual authorized to practice
by this chapter or any applicant for a license or permit suffers such
impairment, the board shall refer the individual to the monitoring
organization that conducts the confidential monitoring program
established under section 4731.25 of the Revised Code. The board also
may compel the individual to submit to a mental or physical
examination, or both. The expense of the examination is the
responsibility of the individual compelled to be examined. Any mental
or physical examination required under this division shall be
undertaken by a treatment provider or physician who is qualified to
conduct the examination and who is approved under section 4731.251 of
the Revised Code.
Failure
to submit to a mental or physical examination ordered by the board
constitutes an admission of the allegations against the individual
unless the failure is due to circumstances beyond the individual's
control, and a default and final order may be entered without the
taking of testimony or presentation of evidence. If the board
determines that the individual's ability to practice is impaired, the
board shall suspend the individual's license or permit or deny the
individual's application and shall require the individual, as a
condition for an initial, continued, reinstated, or renewed license
or permit, to submit to treatment.
Before
being eligible to apply for reinstatement of a license or permit
suspended under this division, the impaired practitioner shall
demonstrate to the board the ability to resume practice in compliance
with acceptable and prevailing standards of care under the provisions
of the practitioner's license or permit. The demonstration shall
include, but shall not be limited to, the following:
(1)
Certification from a treatment provider approved under section
4731.251 of the Revised Code that the individual has successfully
completed any required inpatient treatment;
(2)
Evidence of continuing full compliance with an aftercare contract or
consent agreement;
(3)
Two written reports indicating that the individual's ability to
practice has been assessed and that the individual has been found
capable of practicing according to acceptable and prevailing
standards of care. The reports shall be made by individuals or
providers approved by the board for making the assessments and shall
describe the basis for their determination.
The
board may reinstate a license or permit suspended under this division
after that demonstration and after the individual has entered into a
written consent agreement.
When
the impaired practitioner resumes practice, the board shall require
continued monitoring of the individual. The monitoring shall include,
but not be limited to, compliance with the written consent agreement
entered into before reinstatement or with conditions imposed by board
order after a hearing, and, upon termination of the consent
agreement, submission to the board for at least two years of annual
written progress reports made under penalty of perjury stating
whether the individual has maintained sobriety.
(H)(1)
If either of the following circumstances occur, the secretary and
supervising member may recommend that the board suspend an
individual's license or permit without a prior hearing:
(a)
The secretary and supervising member determine both of the following:
(i)
That there is clear and convincing evidence that an individual has
violated division (A) of this section;
(ii)
That the individual's continued practice presents a danger of
immediate and serious harm to the public.
(b)
The board receives verifiable information that a licensee has been
charged in any state or federal court for a crime classified as a
felony under the charging court's law and the conduct charged
constitutes a violation of division (A) of this section.
(2)
If a recommendation is made to suspend without a prior hearing
pursuant to division (H)(1) of this section, written allegations
shall be prepared for consideration by the board. The board, upon
review of those allegations and by an affirmative vote of not fewer
than six of its members, excluding the secretary and supervising
member, may suspend a license or permit without a prior hearing. A
telephone conference call may be utilized for reviewing the
allegations and taking the vote on the summary suspension.
The
board shall serve a written order of suspension in accordance with
sections 119.05 and 119.07 of the Revised Code. If the individual
subject to the summary suspension requests an adjudicatory hearing by
the board, the date set for the hearing shall be within fifteen days,
but not earlier than seven days, after the individual requests the
hearing, unless otherwise agreed to by both the board and the
individual.
(3)
Any summary suspension imposed under division (H)(2) of this section
is not a final appealable order and is not an adjudication that may
be appealed under section 119.12 of the Revised Code. The summary
suspension shall remain in effect until a final adjudicative order
issued by the board pursuant to this section and Chapter 119. of the
Revised Code becomes effective. Once a final adjudicative order has
been issued by the board, any party adversely affected by it may file
an appeal in accordance with the requirements of Chapter 119. of the
Revised Code.
The
board shall issue its final adjudicative order within seventy-five
days after completion of its hearing. A failure to issue the order
within seventy-five days shall result in dissolution of the summary
suspension order but shall not invalidate any subsequent, final
adjudicative order.
(I)
For purposes of divisions (A)(2), (4), and (6) of this section, the
commission of the act may be established by a finding by the board,
pursuant to an adjudication under Chapter 119. of the Revised Code,
that the individual committed the act. The board does not have
jurisdiction under those divisions if the trial court renders a final
judgment in the individual's favor and that judgment is based upon an
adjudication on the merits. The board has jurisdiction under those
divisions if the trial court issues an order of dismissal upon
technical or procedural grounds.
(J)
The sealing or expungement of conviction records by any court shall
have no effect upon a prior board order entered under this section or
upon the board's jurisdiction to take action under this section if,
based upon a plea of guilty, a judicial finding of guilt, or a
judicial finding of eligibility for intervention in lieu of
conviction, the board issued a notice of opportunity for a hearing
prior to the court's order to seal or expunge the records. The board
shall not be required to seal, destroy, redact, or otherwise modify
its records to reflect the court's sealing or expungement of
conviction records.
(K)
If the board takes action under division (A)(1), (3), or (5) of this
section, and the judicial finding of guilt, guilty plea, or judicial
finding of eligibility for intervention in lieu of conviction is
overturned on appeal, upon exhaustion of the criminal appeal, a
petition for reconsideration of the order may be filed with the board
along with appropriate court documents. Upon receipt of a petition
for reconsideration and supporting court documents, the board shall
reinstate the individual's license or permit. The board may then hold
an adjudication under Chapter 119. of the Revised Code to determine
whether the individual committed the act in question. Notice of an
opportunity for a hearing shall be given in accordance with Chapter
119. of the Revised Code. If the board finds, pursuant to an
adjudication held under this division, that the individual committed
the act or if no hearing is requested, the board may order any of the
sanctions identified under division (A) of this section.
(L)
The license or permit issued to an individual under this chapter and
the individual's practice in this state are automatically suspended
as of the date the individual pleads guilty to, is found by a judge
or jury to be guilty of, or is subject to a judicial finding of
eligibility for intervention in lieu of conviction in this state or
treatment or intervention in lieu of conviction in another
jurisdiction for any of the following criminal offenses in this state
or a substantially equivalent criminal offense in another
jurisdiction: aggravated murder, murder, voluntary manslaughter,
felonious assault, trafficking in persons, kidnapping, rape, sexual
battery, gross sexual imposition, aggravated arson, aggravated
robbery, or aggravated burglary. Continued practice after suspension
shall be considered practicing without a license or permit.
The
board shall serve the individual subject to the suspension in
accordance with sections 119.05 and 119.07 of the Revised Code. If an
individual whose license or permit is automatically suspended under
this division fails to make a timely request for an adjudication
under Chapter 119. of the Revised Code, the board shall enter a final
order permanently revoking the individual's license or permit.
(M)
Notwithstanding any other provision of the Revised Code, all of the
following apply:
(1)
The surrender of a license or permit issued under this chapter shall
not be effective unless or until accepted by the board. A telephone
conference call may be utilized for acceptance of the surrender of an
individual's license or permit. The telephone conference call shall
be considered a special meeting under division (F) of section 121.22
of the Revised Code. Reinstatement of a license or permit surrendered
to the board requires an affirmative vote of not fewer than six
members of the board.
(2)
An application for a license or permit made under the provisions of
this chapter may not be withdrawn without approval of the board.
(3)
Failure by an individual to renew a license or permit in accordance
with this chapter does not remove or limit the board's jurisdiction
to take any disciplinary action under this section against the
individual.
(4)
The placement of an individual's license on retired status, as
described in section 4761.062 of the Revised Code, does not remove or
limit the board's jurisdiction to take any disciplinary action
against the individual with regard to the license as it existed
before being placed on retired status.
(5)
At the request of the board, a license or permit holder shall
immediately surrender to the board a license or permit that the board
has suspended, revoked, or permanently revoked.
Sec.
4761.13.
(A)
As used in this section, "prosecutor" has the same meaning
as in section 2935.01 of the Revised Code.
(B)
The prosecutor in any case against any respiratory care professional
,
advanced practice respiratory therapist,
or
an
individual
holding a limited permit issued under this chapter shall promptly
notify the state medical board of any of the following:
(1)
A plea of guilty to, or a finding of guilt by a jury or court of, a
felony, or a case in which the trial court issues an order of
dismissal upon technical or procedural grounds of a felony charge;
(2)
A plea of guilty to, or a finding of guilt by a jury or court of, a
misdemeanor committed in the course of practice, or a case in which
the trial court issues an order of dismissal upon technical or
procedural grounds of a charge of a misdemeanor, if the alleged act
was committed in the course of practice;
(3)
A plea of guilty to, or a finding of guilt by a jury or court of, a
misdemeanor involving moral turpitude, or a case in which the trial
court issues an order of dismissal upon technical or procedural
grounds of a charge of a misdemeanor involving moral turpitude.
(C)
The report shall include the name and address of the respiratory care
professional
,
advanced practice respiratory therapist,
or person holding a limited permit, the nature of the offense for
which the action was taken, and the certified court documents
recording the action. The board may prescribe and provide forms for
prosecutors to make reports under this section. The form may be the
same as the form required to be provided under section 2929.42 of the
Revised Code.
Sec.
4761.14.
(A)
As used in this section, "criminal conduct" and "sexual
misconduct" have the same meanings as in section 4731.224 of the
Revised Code.
(B)(1)
An employer that disciplines or terminates the employment of a
respiratory care professional
,
advanced practice respiratory therapist,
or individual holding a limited permit issued under this chapter
because of conduct that would be grounds for disciplinary action
under section 4761.09 of the Revised Code shall, not later than
thirty days after the discipline or termination, report the action to
the state medical board. The report shall state the name of the
respiratory care professional
,
advanced practice respiratory therapist,
or individual holding the limited permit and the reason the employer
took the action. If an employer fails to report to the board, the
board may seek an order from the Franklin county court of common
pleas, or any other court of competent jurisdiction, compelling
submission of the report.
(2)
Within thirty days after commencing an investigation regarding
criminal conduct or sexual misconduct against any
respiratory
care professional, advanced practice respiratory therapist, or
individual
holding a
valid
license or
limited
permit issued
pursuant
to
under
this
chapter, a health care facility, including a hospital, health care
facility operated by a health insuring corporation, ambulatory
surgical center, or similar facility or employer, shall report to the
board the name of the
respiratory
care professional, advanced practice respiratory therapist, or
individual
holding
the limited permit
and
a summary of the underlying facts related to the investigation being
commenced.
(C)
If any individual authorized to practice under this chapter or any
professional association or society of such individuals knows or has
reasonable cause to suspect based on facts that would cause a
reasonable person in a similar position to suspect that an individual
authorized to practice under this chapter has committed or
participated in criminal conduct or sexual misconduct the information
upon which the belief is based shall be reported to the board within
thirty days.
This
division does not apply to a professional association or society
whose staff interacts with members of the association or society only
in advocacy, governance, or educational capacities and whose staff
does not regularly interact with members in practice settings.
(D)
In addition to the self-reporting of criminal offenses that is
required for license renewal, an individual authorized to practice
under this chapter shall report to the board criminal charges
regarding criminal conduct, sexual misconduct, or any conduct
involving the use of a motor vehicle while under the influence of
alcohol or drugs, including offenses that are equivalent offenses
under division (A) of section 4511.181 of the Revised Code,
violations of division (D) of section 4511.194 of the Revised Code,
and violations of division (C) of section 4511.79 of the Revised
Code. Reports under this division shall be made within thirty days of
the criminal charge being filed.
Sec.
4761.17.
All
of the following apply to the practice of respiratory care by a
person who holds a license or limited permit issued under this
chapter:
(A)
The person shall practice only pursuant to a prescription or other
order for respiratory care issued by any of the following:
(1)
A physician;
(2)
A clinical nurse specialist, certified nurse-midwife, or certified
nurse practitioner who holds a current, valid license issued under
Chapter 4723. of the Revised Code to practice nursing as an advanced
practice registered nurse and has entered into a standard care
arrangement with a physician;
(3)
A certified registered nurse anesthetist who holds a current, valid
license issued under Chapter 4723. of the Revised Code to practice
nursing as an advanced practice registered nurse and acts in
compliance with sections 4723.43, 4723.433, and 4723.434 of the
Revised Code;
(4)
A physician assistant who holds a valid prescriber number issued by
the state medical board, has been granted physician-delegated
prescriptive authority, and has entered into a supervision agreement
that allows the physician assistant to prescribe or order respiratory
care services
;
(5)
An advanced practice respiratory therapist who has been granted
physician-delegated prescriptive authority and has entered into a
supervision agreement that allows the advanced practice respiratory
therapist to prescribe and order respiratory care services
.
(B)
The person shall practice only under the supervision of any of the
following:
(1)
A physician;
(2)
A certified nurse practitioner, certified nurse-midwife, or clinical
nurse specialist;
(3)
A physician assistant who is authorized to prescribe or order
respiratory care services as provided in division (A)(4) of this
section
;
(4)
An advanced practice respiratory therapist who is authorized to
prescribe or order respiratory care services as provided in division
(A)(5) of this section
.
(C)(1)
When practicing under the prescription or order of a certified nurse
practitioner, certified nurse midwife, or clinical nurse specialist
or under the supervision of such a nurse, the person's administration
of medication that requires a prescription is limited to the drugs
that the nurse is authorized to prescribe pursuant to section
4723.481 of the Revised Code.
(2)
When practicing under the order of a certified registered nurse
anesthetist, the person's administration of medication is limited to
the drugs that the nurse is authorized to order or direct the person
to administer, as provided in sections 4723.43, 4723.433, and
4723.434 of the Revised Code.
(3)
When practicing under the prescription or order of a physician
assistant or under the supervision of a physician assistant, the
person's administration of medication that requires a prescription is
limited to the drugs that the physician assistant is authorized to
prescribe pursuant to the physician assistant's physician-delegated
prescriptive authority.
(4)
When practicing under the prescription or order of an advanced
practice respiratory therapist or under the supervision of an
advanced practice respiratory therapist, the person's administration
of medication that requires a prescription is limited to the drugs
that an advanced practice respiratory therapist is authorized to
prescribe pursuant to the advanced practice respiratory therapist's
physician-delegated prescriptive authority.
Sec.
4761.20.
If
the state medical board has reason to believe that any person who has
been granted a license or limited permit under this chapter is
mentally ill or mentally incompetent, it may file in the probate
court of the county in which such person has a legal residence an
affidavit in the form prescribed in section 5122.11 of the Revised
Code and signed by the board secretary or a member of the secretary's
staff, whereupon the same proceedings shall be had as provided in
Chapter 5122. of the Revised Code. The attorney general may represent
the board in any proceeding commenced under this section.
If
the license holder or limited permit holder is adjudged by a probate
court to be mentally ill or mentally incompetent, the individual's
license or limited permit shall be automatically suspended until the
individual has filed with the board a certified copy of an
adjudication by a probate court of being restored to competency or
has submitted to the board proof, satisfactory to the board, of
having been discharged as being restored to competency in the manner
and form provided in section 5122.38 of the Revised Code. The judge
of the court shall immediately notify the board of an adjudication of
incompetence and note any suspension of a license in the margin of
the court's record of the license.
Sec.
4761.21.
In
the absence of fraud or bad faith, the state medical board, the
board's respiratory care advisory council, a current or former board
or council member, an agent of the board or council, a person
formally requested by the board to be the board's representative or
by the council to be the council's representative, or an employee of
the board or council shall not be held liable in damages to any
person as the result of any act, omission, proceeding, conduct, or
decision related to official duties undertaken or performed pursuant
to this chapter. If any such person requests to be defended by the
state against any claim or action arising out of any act, omission,
proceeding, conduct, or decision related to the person's official
duties, and if the request is made in writing at a reasonable time
before trial and the person requesting defense cooperates in good
faith in the defense of the claim or action, the state shall provide
and pay for the person's defense and shall pay any resulting
judgment, compromise, or settlement. At no time shall the state pay
any part of a claim or judgment that is for punitive or exemplary
damages.
Sec.
4761.30.
A
respiratory care professional
or
advanced practice respiratory therapist
may
provide telehealth services in accordance with section 4743.09 of the
Revised Code.
Sec.
4761.31.
(A)
An individual seeking an initial license to practice as an advanced
practice respiratory therapist shall file with the state medical
board a written application on a form prescribed and supplied by the
board. The application shall be accompanied by the initial license
fee determined by the board. The board shall deposit the fees in
accordance with section 4731.24 of the Revised Code.
(B)
To be eligible for licensure as an advanced practice respiratory
therapist, the individual's application must show, to the
satisfaction of the board, all of the following:
(1)
That the individual has been issued a license to practice respiratory
care under section 4761.05 of the Revised Code;
(2)
That the individual has successfully completed the requirements of a
master's or doctoral educational program approved by the board that
includes instruction in the following areas as they relate to
cardiopulmonary disease: pathophysiology, symptomatology,
differential diagnosis, disease management including the use and
prescription of pharmacologic and nonpharmacologic interventions,
health promotion, and disease prevention;
(3)
That the individual has passed an examination approved under rules
adopted by the board that tests the applicant's knowledge of the
biomedical and clinical sciences relating to advanced respiratory
therapy theory and practice, professional skills and assessment,
management and follow-up for cardiopulmonary disease, and such other
subjects as the board considers useful in determining fitness to
practice;
(4)
That the individual holds an active qualification to practice
advanced practice respiratory care from an organization that is
recognized by the board.
Sec.
4761.311.
An
advanced practice respiratory therapist who fails to maintain an
active qualification to practice advanced practice respiratory care
from an organization that is recognized by the state medical board
shall notify the board not later than fourteen days after the
qualification is no longer active.
Sec.
4761.32.
(A)
The state medical board shall review each application for a license
to practice as an advanced practice respiratory therapist received
under section 4761.31 of the Revised Code. Not later than sixty days
after receiving a complete application, the board shall determine
whether the applicant meets the requirements to receive the license,
as specified in section 4761.31 of the Revised Code.
(B)
If the board determines that an applicant meets the requirements to
receive the license, the secretary of the board shall register the
applicant as an advanced practice respiratory therapist and issue to
the applicant a license to practice as an advanced practice
respiratory therapist.
Sec.
4761.33.
(A)
A license to practice as an advanced practice respiratory therapist
shall be valid for a two-year period unless revoked or suspended. The
license shall expire on the date that is two years after the date of
issuance and may be renewed for additional two-year periods in
accordance with this section. A person seeking to renew a license
shall apply to the state medical board for renewal prior to the
license's expiration date. The board shall provide renewal notices to
license holders at least one month prior to the expiration date.
Applications
shall be submitted to the board in a manner prescribed by the board.
Each application shall be accompanied by the biennial renewal fee
determined by the board. The board shall deposit the fees in
accordance with section 4731.24 of the Revised Code.
The
applicant shall report any criminal offense that constitutes grounds
for refusing to issue a license to practice under section 4761.09 of
the Revised Code to which the applicant has pleaded guilty, of which
the applicant has been found guilty, or for which the applicant has
been found eligible for intervention in lieu of conviction, since
last signing an application for a license to practice as an advanced
practice respiratory therapist.
(B)
To be eligible for renewal of a license, an applicant is subject to
both of the following:
(1)
The applicant must certify to the board that the applicant has
maintained an active qualification to practice advanced practice
respiratory care from an organization that is recognized by the
board.
(2)
The applicant must comply with the renewal eligibility requirements
established under section 4761.49 of the Revised Code that pertain to
the applicant.
(C)
If an applicant submits a complete renewal application and qualifies
for renewal pursuant to division (B) of this section, the board shall
issue to the applicant a renewed license to practice as an advanced
practice respiratory therapist.
Completion
of the continuing education required for an advanced practice
respiratory therapist to maintain an active qualification to practice
advanced practice respiratory care from an organization that is
recognized by the board shall constitute satisfactory completion of
continuing education or reexamination requirements for renewal of a
license to practice respiratory care as set forth in division (B) of
section 4761.06 of the Revised Code.
(D)
The board may require a random sample of advanced practice
respiratory therapists to submit materials documenting both of the
following:
(1)
Maintenance of an active qualification to practice advanced practice
respiratory care from an organization that is recognized by the
board.
(2)
Completion of the continuing education in pharmacology required by
section 4761.49 of the Revised Code.
Division
(D) of this section does not limit the board's authority to conduct
investigations pursuant to section 4761.09 of the Revised Code.
(E)(1)
A license to practice that is not renewed on or before its expiration
date is automatically suspended on its expiration date. Continued
practice after suspension of the license shall be considered as
practicing in violation of section 4761.34 of the Revised Code.
(2)
If an advanced practice respiratory therapist's license to practice
as a respiratory care professional is classified as inactive for any
cause, the advanced practice respiratory therapist's license to
practice as an advanced practice respiratory therapist is
automatically classified as inactive while the license to practice as
a respiratory care professional remains inactive. If either license
held by an advanced practice respiratory therapist is revoked under
this chapter, the other license is automatically revoked. If either
license is suspended under this chapter, including for failure to
renew under this section or section 4761.06 of the Revised Code, the
other license is automatically suspended while the suspension remains
in effect.
(F)
If a license has been suspended pursuant to division (E) of this
section for two years or less, it may be reinstated. The board shall
reinstate a license suspended for failure to renew upon an
applicant's submission of a renewal application, the biennial renewal
fee, and any applicable monetary penalty.
If
a license has been suspended pursuant to division (E) of this section
for more than two years, it may be restored. In accordance with
section 4761.061 of the Revised Code, the board may restore a license
suspended for failure to renew upon an applicant's submission of a
restoration application, the biennial renewal fee, and any applicable
monetary penalty, and compliance with sections 4776.01 to 4776.04 of
the Revised Code. The board shall not restore to an applicant a
license to practice as an advanced practice respiratory therapist
unless the board, in its discretion, decides that the results of the
criminal records check do not make the applicant ineligible for a
license issued pursuant to section 4761.32 of the Revised Code.
The
penalty for reinstatement shall be fifty dollars and the penalty for
restoration shall be one hundred dollars. The board shall deposit
penalties in accordance with section 4731.24 of the Revised Code.
(G)(1)
If, through a random sample conducted under division (D) of this
section or any other means, the board finds that an individual who
certified maintenance of an active qualification or completion of
continuing education in pharmacology required to renew, reinstate, or
restore a license to practice did not complete the requisite
maintenance or continuing education, the board may do either of the
following:
(a)
Take disciplinary action against the individual under section 4761.09
of the Revised Code, impose a civil penalty, or both;
(b)
Permit the individual to agree in writing to re-establish an active
qualification or complete the continuing education and pay a civil
penalty.
(2)
The board's finding in any disciplinary action taken under division
(G)(1)(a) of this section shall be made pursuant to an adjudication
under Chapter 119. of the Revised Code and by an affirmative vote of
not fewer than six of its members.
(3)
A civil penalty imposed under division (G)(1)(a) of this section or
paid under division (G)(1)(b) of this section shall be in an amount
specified by the board of not more than five thousand dollars. The
board shall deposit civil penalties in accordance with section
4731.24 of the Revised Code.
Sec.
4761.34.
(A)
No person shall hold that person out as being able to function as an
advanced practice respiratory therapist, or use any words or letters
indicating or implying that the person is an advanced practice
respiratory therapist, without a current, valid license to practice
as an advanced practice respiratory therapist issued under this
chapter.
(B)
No person shall practice as an advanced practice respiratory
therapist without the supervision, control, and direction of a
supervising physician who specializes in pulmonology, anesthesiology,
critical care, or sleep medicine.
(C)
No person shall practice as an advanced practice respiratory
therapist without having entered into a supervision agreement with a
supervising physician under section 4761.38 of the Revised Code.
(D)
No person acting as the supervising physician of an advanced practice
respiratory therapist shall authorize the advanced practice
respiratory therapist to perform services if either of the following
is the case:
(1)
The services are not within the physician's normal course of practice
and expertise;
(2)
The services are inconsistent with the supervision agreement under
which the advanced practice respiratory therapist is being
supervised, including the policies of the health care facility in
which the physician and the advanced practice respiratory therapist
are practicing.
(E)
No person practicing as an advanced practice respiratory therapist
shall perform general anesthesia, monitored anesthesia care, regional
anesthesia, or neuraxial anesthesia.
(F)
No person shall advertise to provide services as an advanced practice
respiratory therapist, except for the purpose of seeking employment.
(G)
No person practicing as an advanced practice respiratory therapist
shall fail to wear at all times when on duty a placard, plate, or
other device identifying that person as an advanced practice
respiratory therapist.
(H)
No person practicing as an advanced practice respiratory therapist
shall prescribe controlled substances.
(I)
Division (A) of this section does not apply to a person who meets all
of the following conditions:
(1)
The person holds in good standing a valid license or other form of
authority to practice as an advanced practice respiratory therapist
issued by another state.
(2)
The person is practicing as a volunteer without remuneration during a
charitable event that lasts not more than seven days.
(3)
The medical care provided by the person will be supervised by the
medical director of the charitable event or by another physician.
When
a person meets the conditions of this division, the person shall be
deemed to hold, during the course of the charitable event, a license
to practice as an advanced practice respiratory therapist from the
state medical board and shall be subject to the provisions of this
chapter authorizing the board to take disciplinary action against a
license holder. Not less than seven calendar days before the first
day of the charitable event, the person or the event's organizer
shall notify the board of the person's intent to practice as an
advanced practice respiratory therapist at the event. During the
course of the charitable event, the person's scope of practice is
limited to the procedures that an advanced practice respiratory
therapist licensed under this chapter is authorized to perform unless
the person's scope of practice in the other state is more restrictive
than in this state. If the latter is the case, the person's scope of
practice is limited to the procedures that an advanced practice
respiratory therapist in the other state may perform.
Sec.
4761.35.
Nothing
in this chapter shall:
(A)
Be construed to affect or interfere with the performance of duties of
any medical personnel who are either of the following:
(1)
In active service in the army, navy, coast guard, marine corps, air
force, public health service, or marine hospital service of the
United States while so serving;
(2)
Employed by the veterans administration of the United States while so
employed.
(B)
Prevent any person from performing any of the services an advanced
practice respiratory therapist may be authorized to perform, if the
person's professional scope of practice established under any other
chapter of the Revised Code authorizes the person to perform the
services;
(C)
Prohibit a physician from delegating responsibilities to any nurse or
other qualified person who does not hold a license to practice as an
advanced practice respiratory therapist, provided that the individual
does not hold the individual out to be an advanced practice
respiratory therapist;
(D)
Be construed as authorizing an advanced practice respiratory
therapist independently to order or direct the execution of
procedures or techniques by a registered nurse or licensed practical
nurse in the care and treatment of a person, except to the extent
that an advanced practice respiratory therapist is authorized to do
so by a physician who is responsible for supervising the advanced
practice respiratory therapist and the policies of the health care
facility in which the advanced practice respiratory therapist is
practicing.
Sec.
4761.36.
(A)
As used in this section:
(1)
"Disaster" means any imminent threat or actual occurrence
of widespread or severe damage to or loss of property, personal
hardship or injury, or loss of life that results from any natural
phenomenon or act of a human.
(2)
"Emergency" means an occurrence or event that poses an
imminent threat to the health or life of a human.
(B)
Nothing in this chapter prohibits any of the following individuals
from providing medical care, to the extent the individual is able, in
response to a need for medical care precipitated by a disaster or
emergency:
(1)
An individual who holds a license to practice as an advanced practice
respiratory therapist issued under this chapter;
(2)
An individual licensed or authorized to practice as an advanced
practice respiratory therapist in another state;
(3)
An individual employed as an advanced practice respiratory therapist
by an agency, office, or other instrumentality of the federal
government.
(C)
For purposes of the medical care provided by an advanced practice
respiratory therapist pursuant to division (B)(1) of this section,
both of the following apply notwithstanding any supervision
requirement of this chapter to the contrary:
(1)
The physician who supervises the advanced practice respiratory
therapist pursuant to a supervision agreement entered into under
section 4761.38 of the Revised Code is not required to meet the
supervision requirements established under this chapter.
(2)
The physician designated as the medical director of the disaster or
emergency may supervise the medical care provided by the advanced
practice respiratory therapist.
Sec.
4761.37.
(A)
A license to practice as an advanced practice respiratory therapist
issued under this chapter authorizes the holder to practice as an
advanced practice respiratory therapist as follows:
(1)
The advanced practice respiratory therapist shall practice only under
the supervision, control, and direction of a physician with whom the
advanced practice respiratory therapist has entered into a
supervision agreement under section 4761.38 of the Revised Code.
(2)
The advanced practice respiratory therapist shall practice in
accordance with the supervision agreement entered into with the
physician who is responsible for supervising the advanced practice
respiratory therapist, including the policies of the health care
facility in which the advanced practice respiratory therapist is
practicing.
(B)
The state medical board may adopt rules designating hospital-based
facilities to be included as health care facilities that are in
addition to hospitals as specified in division (K)(1) of section
4761.01 of the Revised Code. Any rules adopted shall be adopted in
accordance with Chapter 119. of the Revised Code.
Sec.
4761.38.
(A)
Before initiating supervision of an advanced practice respiratory
therapist, a physician shall enter into a supervision agreement with
the advanced practice respiratory therapist who will be supervised. A
supervision agreement may not apply to more than one advanced
practice respiratory therapist. Only a physician who specializes in
one or more of the following areas is authorized to enter into a
supervision agreement with an advanced practice respiratory therapist
under this section: pulmonology, anesthesiology, critical care, or
sleep medicine.
The
supervision agreement shall specify that the physician agrees to
supervise the advanced practice respiratory therapist and the
advanced practice respiratory therapist agrees to practice under that
physician's supervision. The supervision agreement shall clearly
state that the supervising physician is legally responsible and
assumes legal liability for the services provided by the advanced
practice respiratory therapist. The agreement shall be signed by the
physician and the advanced practice respiratory therapist.
(B)
A supervision agreement shall include all of the following:
(1)
Terms that require the advanced practice respiratory therapist to
practice in accordance with the policies of the health care facility
in which the advanced practice respiratory therapist is practicing;
(2)
Any limitations on the responsibilities to be fulfilled by the
advanced practice respiratory therapist;
(3)
The circumstances under which the advanced practice respiratory
therapist is required to refer a patient to the supervising
physician;
(4)
If the supervising physician chooses to designate physicians to act
as alternate supervising physicians, the names, business addresses,
and business telephone numbers of the physicians who have agreed to
act in that capacity.
(C)
The supervising physician who entered into a supervision agreement
shall retain a copy of the agreement in the records maintained by the
supervising physician. Each advanced practice respiratory therapist
who entered into the supervision agreement shall retain a copy of the
agreement in the records maintained by the advanced practice
respiratory therapist.
(D)(1)
If the board finds, through a review conducted under this section or
through any other means, any of the following, the board may take
disciplinary action against the individual under section 4731.22 or
4761.09 of the Revised Code, impose a civil penalty, or both:
(a)
That an advanced practice respiratory therapist has practiced in a
manner that departs from, or fails to conform to, the terms of a
supervision agreement entered into under this section;
(b)
That a physician has supervised an advanced practice respiratory
therapist in a manner that departs from, or fails to conform to, the
terms of a supervision agreement entered into under this section;
(c)
That a physician or an advanced practice respiratory therapist failed
to comply with division (A) or (B) of this section.
(2)
If the board finds, through a review conducted under this section or
through any other means, that a physician or advanced practice
respiratory therapist failed to comply with division (C) of this
section, the board may do either of the following:
(a)
Take disciplinary action against the individual under section 4731.22
or 4761.09 of the Revised Code, impose a civil penalty, or both;
(b)
Permit the individual to agree in writing to update the records to
comply with division (C) of this section and pay a civil penalty.
(3)
The board's finding in any disciplinary action taken under division
(D) of this section shall be made pursuant to an adjudication
conducted under Chapter 119. of the Revised Code.
(4)
A civil penalty imposed under division (D)(1) or (2)(a) of this
section or paid under division (D)(2)(b) of this section shall be in
an amount specified by the board of not more than five thousand
dollars and shall be deposited in accordance with section 4731.24 of
the Revised Code.
Sec.
4761.39.
(A)
An advanced practice respiratory therapist licensed under this
chapter may perform any of the following services authorized by the
supervising physician that are part of the supervising physician's
normal course of practice and expertise:
(1)
Ordering diagnostic, therapeutic, and other medical services;
(2)
Prescribing physical therapy or referring a patient to a physical
therapist for physical therapy;
(3)
Ordering occupational therapy or referring a patient to an
occupational therapist for occupational therapy;
(4)
If the advanced practice respiratory therapist has been granted
physician-delegated prescriptive authority, ordering, prescribing,
and administering drugs and medical devices;
(5)
Any other services that are part of the supervising physician's
normal course of practice and expertise.
(B)
The services an advanced practice respiratory therapist may provide
under the policies of a health care facility are limited to the
services the facility authorizes the advanced practice respiratory
therapist to provide for the facility. A facility shall not authorize
an advanced practice respiratory therapist to perform a service that
is prohibited under this chapter. A physician who is supervising an
advanced practice respiratory therapist within a health care facility
may impose limitations on the advanced practice respiratory
therapist's practice that are in addition to any limitations
applicable under the policies of the facility.
Sec.
4761.391.
(A)
Acting pursuant to a supervision agreement, an advanced practice
respiratory therapist may delegate performance of a task to implement
a patient's plan of care or, if the conditions in division (C) of
this section are met, may delegate administration of a drug. Subject
to division (D) of section 4761.35 of the Revised Code, delegation
may be to any person. The advanced practice respiratory therapist
must be physically present at the location where the task is
performed or the drug administered.
(B)
Prior to delegating a task or administration of a drug, an advanced
practice respiratory therapist shall determine that the task or drug
is appropriate for the patient and the person to whom the delegation
is to be made may safely perform the task or administer the drug.
(C)
An advanced practice respiratory therapist may delegate
administration of a drug only if all of the following conditions are
met:
(1)
The advanced practice respiratory therapist has been granted
physician-delegated prescriptive authority and is authorized to
prescribe the drug.
(2)
The drug is not a controlled substance.
(3)
The drug will not be administered intravenously.
(4)
The drug will not be administered in a hospital inpatient care unit,
as defined in section 3727.50 of the Revised Code; a hospital
emergency department; a freestanding emergency department; or an
ambulatory surgical facility licensed under section 3702.30 of the
Revised Code.
(D)
A person not otherwise authorized to administer a drug or perform a
specific task may do so in accordance with an advanced practice
respiratory therapist's delegation under this section.
Sec.
4761.40.
(A)
The supervising physician of an advanced practice respiratory
therapist exercises supervision, control, and direction of the
advanced practice respiratory therapist. An advanced practice
respiratory therapist may practice in any health care facility within
which the supervising physician has supervision, control, and
direction of the advanced practice respiratory therapist.
In
supervising an advanced practice respiratory therapist, all of the
following apply:
(1)
The supervising physician shall provide only on-site supervision,
consisting of being physically present at the location where the
advanced practice respiratory therapist is practicing and being
continuously available for direct communication with the advanced
practice respiratory therapist.
(2)
The supervising physician shall personally and actively review the
advanced practice respiratory therapist's professional activities.
(3)
The supervising physician shall ensure that the quality assurance
system established pursuant to division (F) of this section is
implemented and maintained.
(4)
The supervising physician shall regularly perform any other reviews
of the advanced practice respiratory therapist that the supervising
physician considers necessary.
(B)
A physician may enter into supervision agreements with any number of
advanced practice respiratory therapists, but the physician may not
supervise more than five advanced practice respiratory therapists at
any one time. An advanced practice respiratory therapist may enter
into supervision agreements with any number of supervising
physicians.
(C)
A supervising physician may authorize an advanced practice
respiratory therapist to perform a service only if the physician is
satisfied that the advanced practice respiratory therapist is capable
of competently performing the service. A supervising physician shall
not authorize an advanced practice respiratory therapist to perform
any service that is beyond the physician's or the advanced practice
respiratory therapist's normal course of practice and expertise.
(D)
In the case of a health care facility with an emergency department,
the supervising physician may, on occasion, send the advanced
practice respiratory therapist to the facility's emergency department
to assess a patient. In supervising the advanced practice respiratory
therapist's assessment of the patient, the supervising physician
shall determine the appropriate level of supervision in compliance
with the requirements of divisions (A) to (C) of this section, except
that the supervising physician must be available to go to the
emergency department to personally evaluate the patient and, at the
request of an emergency department physician, the supervising
physician shall go to the emergency department to personally evaluate
the patient.
(E)
Each time an advanced practice respiratory therapist writes a medical
order, including prescriptions written in the exercise of
physician-delegated prescriptive authority, the advanced practice
respiratory therapist shall sign the form on which the order is
written and record on the form the time and date that the order is
written.
(F)(1)
The supervising physician of an advanced practice respiratory
therapist shall establish a quality assurance system to be used in
supervising the advanced practice respiratory therapist. All or part
of the system may be applied to other advanced practice respiratory
therapists who are supervised by the supervising physician. The
system shall be developed in consultation with each advanced practice
respiratory therapist to be supervised by the physician.
(2)
In establishing the quality assurance system, the supervising
physician shall describe a process to be used for all of the
following:
(a)
Routine review by the physician of selected patient record entries
made by the advanced practice respiratory therapist and selected
medical orders issued by the advanced practice respiratory therapist;
(b)
Discussion of complex cases;
(c)
Discussion of new medical developments relevant to the practice of
the physician and advanced practice respiratory therapist;
(d)
Performance of any quality assurance activities required in rules
adopted by the state medical board pursuant to any recommendations
made by the respiratory care advisory council under section 4761.032
of the Revised Code;
(e)
Performance of any other quality assurance activities that the
supervising physician considers to be appropriate.
(3)
The supervising physician and advanced practice respiratory therapist
shall keep records of their quality assurance activities. On request,
the records shall be made available to the board.
Sec.
4761.41.
(A)
When performing authorized services, an advanced practice respiratory
therapist acts as the agent of the advanced practice respiratory
therapist's supervising physician. The supervising physician is
legally responsible and assumes legal liability for the services
provided by the advanced practice respiratory therapist.
The
physician is not responsible or liable for any services provided by
the advanced practice respiratory therapist after their supervision
agreement expires or is terminated.
(B)
When a health care facility permits advanced practice respiratory
therapists to practice within that facility or any other health care
facility under its control, the health care facility shall make
reasonable efforts to explain to each individual who may work with a
particular advanced practice respiratory therapist the scope of that
advanced practice respiratory therapist's practice within the
facility. The appropriate credentialing body within the health care
facility shall provide, on request of an individual practicing in the
facility with an advanced practice respiratory therapist, a copy of
the facility's policies on the practice of advanced practice
respiratory therapists within the facility and a copy of each
supervision agreement applicable to the advanced practice respiratory
therapist.
An
individual who follows the orders of an advanced practice respiratory
therapist practicing in a health care facility is not subject to
disciplinary action by any administrative agency that governs that
individual's conduct and is not liable in damages in a civil action
for injury, death, or loss to person or property resulting from the
individual's acts or omissions in the performance of any procedure,
treatment, or other health care service if the individual reasonably
believed that the advanced practice respiratory therapist was acting
within the proper scope of practice or was relaying medical orders
from a supervising physician, unless the act or omission constitutes
willful or wanton misconduct.
Sec.
4761.42.
A
license issued by the state medical board under section 4761.32 of
the Revised Code authorizes the license holder to be granted
physician-delegated prescriptive authority and to exercise that
authority as provided in division (A)(4) of section 4761.39 and
section 4761.45 of the Revised Code. The board shall issue a
prescriber number to each advanced practice respiratory therapist
licensed under this chapter.
Sec.
4761.44.
The
state medical board shall adopt rules governing physician-delegated
prescriptive authority for advanced practice respiratory therapists.
The rules shall be adopted in accordance with Chapter 119. of the
Revised Code and shall establish, at a minimum, requirements
regarding the pharmacology courses that an advanced practice
respiratory therapist is required to complete.
Sec.
4761.45.
An
advanced practice respiratory therapist is authorized to prescribe
drugs and therapeutic devices in the exercise of physician-delegated
prescriptive authority, subject to all of the following:
(A)
An advanced practice respiratory therapist shall exercise
physician-delegated prescriptive authority only to the extent that
the physician supervising the advanced practice respiratory therapist
has granted that authority.
(B)
An advanced practice respiratory therapist shall comply with all
conditions placed on the physician-delegated prescriptive authority,
as specified by the supervising physician who is supervising the
advanced practice respiratory therapist in the exercise of
physician-delegated prescriptive authority.
(C)
An advanced practice respiratory therapist's physician-delegated
prescriptive authority shall not include the authority to do either
of the following:
(1)
Prescribe a controlled substance;
(2)
Personally furnish any drug.
(D)
An advanced practice respiratory therapist shall not prescribe any
drug in violation of state or federal law.
Sec.
4761.46.
(A)
In granting physician-delegated prescriptive authority to a
particular advanced practice respiratory therapist, the supervising
physician shall supervise the advanced practice respiratory therapist
in accordance with both of the following:
(1)
The supervision requirements specified in section 4761.40 of the
Revised Code;
(2)
The supervision agreement entered into with the advanced practice
respiratory therapist under section 4761.38 of the Revised Code,
including the policies of the health care facility in which the
physician and advanced practice respiratory therapist are practicing.
(B)(1)
The supervising physician of an advanced practice respiratory
therapist may place conditions on the physician-delegated
prescriptive authority granted to the advanced practice respiratory
therapist. If conditions are placed on that authority, the
supervising physician shall maintain a written record of the
conditions and make the record available to the state medical board
on request.
(2)
The conditions that a supervising physician may place on the
physician-delegated prescriptive authority granted to an advanced
practice respiratory therapist include the following:
(a)
Identification by class and specific generic nomenclature of drugs
and therapeutic devices that the physician chooses not to permit the
advanced practice respiratory therapist to prescribe;
(b)
Limitations on the dosage units or refills that the advanced practice
respiratory therapist is authorized to prescribe;
(c)
Specification of circumstances under which the advanced practice
respiratory therapist is required to refer patients to the
supervising physician or another physician when exercising
physician-delegated prescriptive authority;
(d)
Responsibilities to be fulfilled by the physician in supervising the
advanced practice respiratory therapist that are not otherwise
specified in the supervision agreement or otherwise required by this
chapter.
Sec.
4761.49.
(A)
To be eligible for renewal of a license to practice as an advanced
practice respiratory therapist, an applicant who has been granted
physician-delegated prescriptive authority shall complete every two
years at least twelve hours of continuing education in pharmacology
obtained through a program or course approved by the state medical
board or a person the board has authorized to approve continuing
pharmacology education programs and courses. Except as provided in
section 5903.12 of the Revised Code, the continuing education shall
be completed not later than the date on which the applicant's license
expires.
(B)
The state medical board shall provide for pro rata reductions by
month of the number of hours of continuing education in pharmacology
that is required to be completed for advanced practice respiratory
therapists who have been disabled due to illness or accident or have
been absent from the country. The board shall adopt rules, in
accordance with Chapter 119. of the Revised Code, as necessary to
implement this division.
(C)
The continuing education required by this section is in addition to
the requirement of section 4761.33 of the Revised Code to maintain an
active qualification to practice advanced practice respiratory care
from an organization that is recognized by the state medical board.
(D)
If the state medical board chooses to authorize persons to approve
continuing pharmacology education programs and courses, the board
shall establish standards for granting that authority and grant the
authority in accordance with the standards.
Sec.
4761.99.
Whoever
violates division (A) of section 4761.10 of the Revised Code is
guilty of a minor misdemeanor on a first offense. On a second
offense, the person is guilty of a misdemeanor of the fourth degree.
On each subsequent offense, the person is guilty of a misdemeanor of
the first degree.
Whoever
violates division (B)(2) or (C) of section 4761.14 of the Revised
Code is guilty of a misdemeanor of the fourth degree; on each
subsequent offense, the person is guilty of a misdemeanor of the
first degree.
Whoever
violates division
(E)(5)
(E)(6)
of section 4761.03 of the Revised Code is guilty of a misdemeanor of
the first degree.
Whoever
violates section 4761.34 of the Revised Code is guilty of a
misdemeanor of the first degree on a first offense. On each
subsequent offense, the person is guilty of a felony of the fourth
degree.
Sec.
4765.51.
Nothing
in this chapter prevents or restricts the practice, services, or
activities of any registered nurse practicing within the scope of the
registered nurse's practice.
Nothing
in this chapter prevents or restricts the practice, services, or
activities of any physician assistant practicing in accordance with a
supervision agreement entered into under section 4730.19 of the
Revised Code, including, if applicable, the policies of the health
care facility in which the physician assistant is practicing.
Nothing
in this chapter prevents or restricts the practice, services, or
activities of any advanced practice respiratory therapist practicing
in accordance with a supervision agreement entered into under section
4761.38 of the Revised Code, including the policies of the health
care facility in which the advanced practice respiratory therapist is
practicing.
Nothing
in this chapter prevents or restricts the practice, services, or
activities of any certified mental health assistant practicing in
accordance with a supervision agreement entered into under section
4772.10 of the Revised Code.
Sec.
4769.01.
As
used in this chapter:
(A)
"Medicare" means the program established by Title XVIII of
the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A.
301, as amended.
(B)
"Balance billing" means charging or collecting from a
medicare beneficiary an amount in excess of the medicare
reimbursement rate for medicare-covered services or supplies provided
to a medicare beneficiary, except when medicare is the secondary
insurer. When medicare is the secondary insurer, the health care
practitioner may pursue full reimbursement under the terms and
conditions of the primary coverage and, if applicable, the charge
allowed under the terms and conditions of the appropriate provider
contract, from the primary insurer, but the medicare beneficiary
cannot be balance billed above the medicare reimbursement rate for a
medicare-covered service or supply. "Balance billing" does
not include charging or collecting deductibles or coinsurance
required by the program.
(C)
"Health care practitioner" means all of the following:
(1)
A dentist or dental hygienist licensed under Chapter 4715. of the
Revised Code;
(2)
A registered or licensed practical nurse licensed under Chapter 4723.
of the Revised Code;
(3)
An optometrist licensed under Chapter 4725. of the Revised Code;
(4)
A dispensing optician,
whether
a
spectacle
dispensing optician
,
or spectacle-contact lens dispensing optician
,
licensed under Chapter 4725. of the Revised Code;
(5)
A pharmacist licensed under Chapter 4729. of the Revised Code;
(6)
A physician authorized under Chapter 4731. of the Revised Code to
practice medicine and surgery, osteopathic medicine and surgery, or
podiatry
podiatric
medicine and surgery
;
(7)
A physician assistant authorized under Chapter 4730. of the Revised
Code to practice as a physician assistant;
(8)
A practitioner of a limited branch of medicine issued a certificate
under Chapter 4731. of the Revised Code;
(9)
A psychologist licensed under Chapter 4732. of the Revised Code;
(10)
A chiropractor licensed under Chapter 4734. of the Revised Code;
(11)
A hearing aid dealer or fitter licensed under Chapter 4747. of the
Revised Code;
(12)
A speech-language pathologist or audiologist licensed under Chapter
4753. of the Revised Code;
(13)
An occupational therapist or occupational therapy assistant licensed
under Chapter 4755. of the Revised Code;
(14)
A physical therapist or physical therapy assistant licensed under
Chapter 4755. of the Revised Code;
(15)
A licensed professional clinical counselor, licensed professional
counselor, social worker, or independent social worker licensed, or a
social work assistant registered, under Chapter 4757. of the Revised
Code;
(16)
A dietitian licensed under Chapter 4759. of the Revised Code;
(17)
A respiratory care professional
or
advanced practice respiratory therapist
licensed
under Chapter 4761. of the Revised Code;
(18)
An emergency medical technician-basic, emergency medical
technician-intermediate, or emergency medical technician-paramedic
certified under Chapter 4765. of the Revised Code;
(19)
A certified mental health assistant licensed under Chapter 4772. of
the Revised Code.
Sec.
5123.47.
(A)
As used in this section:
(1)
"In-home care" means the supportive services provided
within the home of an individual with a developmental disability who
receives funding for the services through a county board of
developmental disabilities, including any recipient of residential
services funded as home and community-based services, family support
services provided under section 5126.11 of the Revised Code, or
supported living provided in accordance with sections 5126.41 to
5126.47 of the Revised Code. "In-home care" includes care
that is provided outside an individual's home in places incidental to
the home, and while traveling to places incidental to the home,
except that "in-home care" does not include care provided
in the facilities of a county board of developmental disabilities or
care provided in schools.
(2)
"Parent" means either parent of a child, including an
adoptive parent but not a foster parent.
(3)
"Unlicensed in-home care worker" means an individual who
provides in-home care on a self-employed basis and does not employ,
either directly or through contract, another person to provide the
in-home care, but who is not a health care professional.
(4)
"Health care professional" means any of the following:
(a)
A dentist who holds a valid license issued under Chapter 4715. of the
Revised Code;
(b)
A registered or licensed practical nurse who holds a valid license
issued under Chapter 4723. of the Revised Code;
(c)
An optometrist who holds a valid license issued under Chapter 4725.
of the Revised Code;
(d)
A pharmacist who holds a valid license issued under Chapter 4729. of
the Revised Code;
(e)
A person who holds a valid license or certificate issued under
Chapter 4731. of the Revised Code to practice medicine and surgery,
osteopathic medicine and surgery, podiatric medicine and surgery, or
a limited brand of medicine;
(f)
A physician assistant who holds a valid license issued under Chapter
4730. of the Revised Code;
(g)
An occupational therapist or occupational therapy assistant or a
physical therapist or physical therapist assistant who holds a valid
license issued under Chapter 4755. of the Revised Code;
(h)
A respiratory care professional
or
advanced practice respiratory therapist
who
holds a valid license issued under Chapter 4761. of the Revised Code;
(i)
A certified mental health assistant who holds a valid license issued
under Chapter 4772. of the Revised Code.
(5)
"Health care task" means a task that is prescribed,
ordered, or otherwise directed by a health care professional acting
within the scope of the professional's practice. "Health care
task" includes the administration of medications.
(B)
Except as provided in division (F) of this section, a family member
of an individual with a developmental disability may authorize an
unlicensed in-home care worker to perform health care tasks as part
of the in-home care the worker provides to the individual, if all of
the following apply:
(1)
The family member is the primary supervisor of the care.
(2)
At the time the family member both authorizes the unlicensed in-home
care worker to perform health care tasks and supervises the care
provided to the individual, the family member is not acting as a paid
provider for the individual.
(3)
The unlicensed in-home care worker has been selected by the family
member or the individual receiving care and is under the direct
supervision of the family member.
(4)
The health care task is completed in accordance with standard,
written instructions.
(5)
Performance of the health care task requires no judgment based on
specialized health care knowledge or expertise.
(6)
The outcome of the health care task is reasonably predictable.
(7)
Performance of the health care task requires no complex observation
of the individual receiving the care.
(8)
Improper performance of the health care task will result in only
minimal complications that are not life-threatening.
(C)
A family member who authorizes an unlicensed in-home care worker to
perform health care tasks under this section shall do all of the
following:
(1)
Obtain a prescription, if applicable, and written instructions from a
health care professional for the care to be provided to the
individual;
(2)
Authorize the unlicensed in-home care worker to provide the care by
preparing a written document granting the authority;
(3)
Provide the unlicensed in-home care worker with appropriate training
and written instructions in accordance with the instructions obtained
from the health care professional;
(4)
Be available to communicate with the unlicensed in-home care worker
either in person or by telecommunication while the in-home care
worker performs a health care task.
(D)
Before an unlicensed in-home care worker may perform the health care
tasks authorized by a family member under this section, the worker
shall accept the written document described in division (C)(2) of
this section granting the worker that authority.
(E)
A family member who authorizes an unlicensed in-home care worker to
perform health care tasks retains full responsibility for the health
and safety of the individual receiving the care and for ensuring that
the worker provides the care appropriately and safely. No entity that
funds or monitors the provision of in-home care may be held liable
for the results of the care provided under this section by an
unlicensed in-home care worker, including such entities as the county
board of developmental disabilities and the department of
developmental disabilities.
An
unlicensed in-home care worker who is authorized under this section
by a family member to provide care to an individual may not be held
liable for any injury caused in providing the care, unless the worker
provides the care in a manner that is not in accordance with the
training and instructions received or the worker acts in a manner
that constitutes willful or wanton misconduct.
(F)
A county board of developmental disabilities may evaluate the
authority granted by a family member under this section to an
unlicensed in-home care worker at any time it considers necessary and
shall evaluate the authority on receipt of a complaint. In evaluating
the authority, the board shall use appropriately licensed health care
professionals.
If,
after its evaluation, the board determines that a family member has
acted in a manner that is inappropriate for the health and safety of
the individual receiving the care, then all of the following apply:
(1)
The authorization granted by the family member to an unlicensed
in-home care worker is void.
(2)
The family member may not authorize other unlicensed in-home care
workers to provide the care.
(3)
The board shall authorize appropriately licensed or certified
providers to instead perform the health care tasks.
(4)
The board shall provide the family member an opportunity to file a
complaint under section 5126.06 of the Revised Code.
Sec.
5164.95.
(A)
As used in this section, "telehealth service" means a
health care service delivered to a patient through the use of
interactive audio, video, or other telecommunications or electronic
technology from a site other than the site where the patient is
located.
(B)
The department of medicaid shall establish standards for medicaid
payments for health care services the department determines are
appropriate to be covered by the medicaid program when provided as
telehealth services. The standards shall be established in rules
adopted under section 5164.02 of the Revised Code.
In
accordance with section 5162.021 of the Revised Code, the medicaid
director shall adopt rules authorizing the directors of other state
agencies to adopt rules regarding the medicaid coverage of telehealth
services under programs administered by the other state agencies. Any
such rules adopted by the medicaid director or the directors of other
state agencies are not subject to the requirements of division (F) of
section 121.95 of the Revised Code.
(C)(1)
To the extent permitted under rules adopted under section 5164.02 of
the Revised Code and applicable federal law, the following
practitioners are eligible to provide telehealth services covered
pursuant to this section:
(a)
A physician licensed under Chapter 4731. of the Revised Code to
practice medicine and surgery, osteopathic medicine and surgery, or
podiatric medicine and surgery;
(b)
A psychologist, independent school psychologist, or school
psychologist licensed under Chapter 4732. of the Revised Code;
(c)
A physician assistant licensed under Chapter 4730. of the Revised
Code;
(d)
A clinical nurse specialist, certified nurse-midwife, or certified
nurse practitioner licensed under Chapter 4723. of the Revised Code;
(e)
An independent social worker, independent marriage and family
therapist, or professional clinical counselor licensed under Chapter
4757. of the Revised Code;
(f)
An independent chemical dependency counselor licensed under Chapter
4758. of the Revised Code;
(g)
A supervised practitioner or supervised trainee;
(h)
An audiologist or speech-language pathologist licensed under Chapter
4753. of the Revised Code;
(i)
An audiology aide or speech-language pathology aide, as defined in
section 4753.072 of the Revised Code, or an individual holding a
conditional license under section 4753.071 of the Revised Code;
(j)
An occupational therapist or physical therapist licensed under
Chapter 4755. of the Revised Code;
(k)
An occupational therapy assistant or physical therapist assistant
licensed under Chapter 4755. of the Revised Code.
(l)
A dietitian licensed under Chapter 4759. of the Revised Code;
(m)
A chiropractor licensed under Chapter 4734. of the Revised Code;
(n)
A pharmacist licensed under Chapter 4729. of the Revised Code;
(o)
A genetic counselor licensed under Chapter 4778. of the Revised Code;
(p)
An optometrist licensed under Chapter 4725. of the Revised Code to
practice optometry;
(q)
A respiratory care professional
or
advanced practice respiratory therapist
licensed
under Chapter 4761. of the Revised Code;
(r)
A certified Ohio behavior analyst certified under Chapter 4783. of
the Revised Code;
(s)
A practitioner who provides services through a medicaid school
program;
(t)
Subject to section 5119.368 of the Revised Code, a practitioner
authorized to provide services and supports certified under section
5119.36 of the Revised Code through a community mental health
services provider or community addiction services provider;
(u)
A certified mental health assistant licensed under Chapter 4772. of
the Revised Code;
(v)
Any other practitioner the medicaid director considers eligible to
provide telehealth services.
(2)
In accordance with division (B) of this section and to the extent
permitted under rules adopted under section 5164.02 of the Revised
Code and applicable federal law, the following provider types are
eligible to submit claims for medicaid payments for providing
telehealth services:
(a)
Any practitioner described in division (C)(1) of this section, except
for those described in divisions (C)(1)(g), (i), and (k) of this
section;
(b)
A professional medical group;
(c)
A federally qualified health center or federally qualified health
center look-alike, as defined in section 3701.047 of the Revised
Code;
(d)
A rural health clinic;
(e)
An ambulatory health care clinic;
(f)
An outpatient hospital;
(g)
A medicaid school program;
(h)
Subject to section 5119.368 of the Revised Code, a community mental
health services provider or community addiction services provider
that offers services and supports certified under section 5119.36 of
the Revised Code;
(i)
Any other provider type the medicaid director considers eligible to
submit the claims for payment.
(D)(1)
When providing telehealth services under this section, a practitioner
shall comply with all requirements under state and federal law
regarding the protection of patient information. A practitioner shall
ensure that any username or password information and any electronic
communications between the practitioner and a patient are securely
transmitted and stored.
(2)
When providing telehealth services under this section, every
practitioner site shall have access to the medical records of the
patient at the time telehealth services are provided.
Sec.
5903.12.
(A)
As used in this section:
"Continuing
education" means continuing education required of a licensee by
law and includes, but is not limited to, the continuing education
required of licensees under sections 3737.881, 3776.07, 3781.10,
4701.11, 4715.141, 4715.25, 4717.09, 4723.24, 4725.16, 4725.51,
4730.14, 4730.49, 4731.155, 4731.282, 4734.25, 4735.141, 4741.16,
4741.19, 4751.24, 4751.25, 4755.63, 4757.33, 4759.06, 4761.06,
4761.49,
4763.07,
and 4772.081 of the Revised Code.
"Reporting
period" means the period of time during which a licensee must
complete the number of hours of continuing education required of the
licensee by law.
(B)
A licensee may submit an application to a licensing agency, stating
that the licensee requires an extension of the current reporting
period because the licensee has served on active duty during the
current or a prior reporting period. The licensee shall submit proper
documentation certifying the active duty service and the length of
that active duty service. Upon receiving the application and proper
documentation, the licensing agency shall extend the current
reporting period by an amount of time equal to the total number of
months that the licensee spent on active duty during the current
reporting period. For purposes of this division, any portion of a
month served on active duty shall be considered one full month.
Section
2.
That
existing sections 2305.234, 2925.01, 2925.23, 2925.55, 2925.56,
3701.048, 3701.74, 3715.872, 3719.121, 3719.13, 3719.81, 4729.01,
4729.51, 4731.22
,
4731.2210
,
4731.25, 4743.09, 4755.48, 4761.01, 4761.03, 4761.032, 4761.06,
4761.061, 4761.07, 4761.09, 4761.13, 4761.14, 4761.17, 4761.30,
4761.99, 4765.51, 4769.01, 5123.47, 5164.95, and 5903.12 of the
Revised Code are hereby repealed.
Section
3.
The
General Assembly, applying the principle stated in division (B) of
section 1.52 of the Revised Code that amendments are to be harmonized
if reasonably capable of simultaneous operation, finds that the
following sections, presented in this act as composites of the
sections as amended by the acts indicated, are the resulting versions
of the sections in effect prior to the effective date of the sections
as presented in this act:
Section
2925.23 of the Revised Code as amended by both H.B. 29 and S.B. 95 of
the 135th General Assembly.
Section
3701.74 of the Revised Code as amended by both S.B. 95 and S.B. 196
of the 135th General Assembly.
Section
3715.872 of the Revised Code as amended by both S.B. 95 and S.B. 196
of the 135th General Assembly.